![]() Narcolepsy type 2, which is considered a milder form of narcolepsy without catalepsy, we really don’t know what causes that at all. It’s sort of a series of unfortunate events, if you will, that can cause it, but we’re still trying to tease apart all the details of that interaction. The majority of patients with narcolepsy type 1 are positive for a specific haplotype-the HLA DQB-0602 haplotype-and so we think there must be some interaction between these agents, such as sort of an environmental stressor and then a genetic propensity to have narcolepsy. We think of it as an autoimmune condition in type 1, where have been associations with specific viruses and specific vaccinations and specific bacteria like strep that precede narcolepsy onset. Kiran Maski, MD, MPH: We’re still trying to understand the mechanisms that cause narcolepsy. NeurologyLive: What do we know now about pediatric narcolepsy that we did not 10 years ago? The director of the sleep clinic and assistant professor of neurology at Harvard Medical School spoke with NeurologyLive in an interview to further discuss what has been learned about the condition in the last decade, as well as what questions remain unanswered. In order to better address the diagnosis and treatment of pediatric narcolepsy, Maski pointed to a need for improved understanding of the condition as a whole. Not only is delayed diagnosis an issue, but misdiagnosis is common for the disorder, with many of its symptoms-cataplexy and sleepiness, for example-causing clinicians to confuse it for other conditions such as depression or attention-deficit/hyperactivity disorder. Although progress has been made in the scientific understanding of the less-than-common condition of pediatric narcolepsy, for Kiran Maski, MD, MPH, there is still a long way to go to complete the medical community’s knowledge of it.
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