Recognition and management of narcolepsy.

Perhaps as many as 5% of adults are excessively sleepy to a clinically relevant extent. The comparable figure for children is not known, but sleepiness is associated with many diVerent conditions and, although a neglected topic, it can be the cause of serious psychological and social disadvantage. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not the rarity once supposed, and poses special problems of recognition and management, especially in young people. The purpose of this article is mainly to review the clinical picture of narcolepsy in children and adolescents, emphasising the need for paediatricians, child psychiatrists, and others to take a wide view of the ways in which the condition can show itself. The clinical picture is often very different from that of the fully developed narcolepsy syndrome in adults. It is, therefore, at particular risk of either being overlooked or misconstrued.