S15: Pediatric narcolepsy: From clinical features to therapeutic outcome

S15: Pediatric narcolepsy: From clinical features to therapeutic outcome
Sunday, April 29 | 10:40am-12:10pm| Room 341

Chair: Judith Owens (USA)

Clinical aspects in the narcoleptic child: How clinical evaluation may orientate towards therapeutic decisions
Giuseppe Plazzi (Italy)

Auto-immunity and pediatric narcolepsy
Lucie Barateau (France)

Pediatric narcolepsy and psychiatric features
Paul Gringras (United Kingdom)

Management of the pediatric narcoleptic patient
Michel Lecendreux (France)

Directions for the future, what can we expect regarding narcolepsy and other disorders of EDS based on current research?
Yves Dauvilliers (France)


Summary of symposium:
Narcolepsy is a chronic and disabling disorder affecting sleep and wakefulness, characterized by excessive daytime sleepiness (EDS), sudden sleep episodes and attacks of muscle atonia mostly triggered by emotions (cataplexy). Narcolepsy is a lifelong disorder, however not progressive, and which occurrence during childhood is frequent. Among others, the occurrence of the disorder during childhood and adolescence should be taken into consideration. Narcolepsy in children and adolescents is still under-diagnosed and is often mistaken in its onset for other diseases or even neglected.

Young patients affected by the disorder often show dramatic and abrupt impairment in their social skills and academic performances due to excessive daytime sleepiness, fatigue and lack of energy. The goal of the symposium is to underlie the clinical characteristics of pediatric narcolepsy and to highlight the therapeutic outcome for the disorder. All speakers are well known experts in the field of narcolepsy and pediatrics who will provide useful information from their clinical practice and/or specific research. For each topic, speakers will focus on clinical and therapeutic specificities in childhood and adolescent narcolepsy. The overall discussion will be facilitated by Dr Judith Owens.

Dr Plazzi’s presentation will focus on clinical features in the narcoleptic child. Childhood narcolepsy is characterized by features different from adults, which would require aspecific assessment, including excessive daytime sleepiness, cataplexy, sleep paralysis, hallucinations, and polygraphic findings. The presentation will discuss the specific features of childhood narcolepsy, and how clinical evaluation may orientate towards therapeutic decisions. Dr Barateau will bring scientific evidence on the relationship of narcolepsy in children and auto-immunity. This topic will be particularly relevant for pediatricians. Dr Gringras will focus on the alterations in mood and behavior (including autism) in children and adolescents with narcolepsy. Those may be a consequence of the primary disorder itself, social adaptation difficulties or drug therapy. They tend to exacerbate the underlying sleep-wake disorder and also further impair the quality of life. The presentation will review the available data on this topic and offer recommendations for management. Dr Lecendreux will discuss the current treatment of pediatric narcolepsy which is so far essentially symptomatic, with no prospect, at the present time, of a definitive cure or even remission for subjects who are obliged to take psychotropic medication on a long-term basis. Considering the repercussion of the disorder and its dramatic consequences in children and/or adolescents, medication is often required at a very early stage of the disease, and in many cases soon after the diagnosis is confirmed. Finally, Dr Dauvilliers will discuss the new therapeutic trends in narcolepsy and other disorders of EDS and bring some perspectives in the management of patients in the future based on basic and clinical research.

Our hope for the future is that specific therapies such as immunosuppressive therapies, antibiotherapy or other alternatives, administrated close to the onset of the disease will provide a real opportunity for the children to improve their condition on a long-term basis.

Learning Objectives:
Upon Completion of this CME activity, participants should be able to:
1 To increase awareness and improve diagnosis of narcolepsy and cataplexy in children
2 To help clarify the role of clinical investigation in the management of narcoleptic children
3 To better understand the underlying mechanisms involved in pediatric narcolepsy
4 To become more familiar with psychiatric comorbidities related to pediatric narcolepsy
5 To describe current treatment and new perspectives in the management of narcoleptic children and adolescents

Target Audience:
Physicians, pediatricians, sleep specialists involved with children and adolescents, child psychiatrists, psychologists, neuro-pediatricians, specialists in Narcolepsy and Hypersomnias