In an interview with NeurologyLive, Michael Thorpy, MBChB, spoke about the challenges of diagnosing narcolepsy and the implications for a multimodal therapy approach.

Cataplexy is very difficult to diagnose. Some patients laugh and fall to the ground, in which case it’s easy to diagnose. But some patients have subtle evidence of cataplexy; even the patient may not be aware that they’re having it. It may be noticed by other family members and might be just a little bobbing of the head, or the head coming down, the eyelids coming down, flattening of the face, or sometimes it’s a little dysarthria—patients speaking and the voice becomes slurred. They can be very subtle, and for that reason it’s often missed and that adds to this delay in diagnosis of narcolepsy.