Effective treatment of narcolepsy-like symptoms with high-frequency repetitive transcranial magnetic stimulation

RATIONALE Narcolepsy is a rare sleep disorder with disrupted sleep-architecture. Clinical management of narcolepsy lies dominantly on symptom-driven pharmacotherapy. The treatment role of repetitive transcranial magnetic stimulation (rTMS) for narcolepsy remains unexplored. PATIENT CONCERNS In this paper, we present a case of a 14-year-old young girl with excessive daytime sleepiness (EDS), cataplexy and hypnagogic hallucinations. DIAGNOSES After excluding other possible medical conditions, this patient was primarily diagnosed with narcolepsy. INTERVENTIONS The patient received 25 sessions of high-frequency rTMS over the left dorsolateral prefrontal cortex (DLPFC). OUTCOMES The symptoms of EDS and cataplexy significantly improved after rTMS treatment. Meanwhile, her score in the Epworth sleep scale (ESS) also remarkably decreased. LESSONS This case indicates that rTMS may be selected as a safe and effective alternative strategy for treating narcolepsy-like symptoms. Well-designed researches are warranted in future investigations on this topic.