Functional (Dissociative) Narcolepsy: A Case Report and Literature Review

Functional neurological disorders (FND) are dissociative conditions characterized by an involuntary disruption in the integration of motor, sensory, or cognitive functions, occurring in the absence of structural or biochemical abnormalities. FND can manifest with symptoms that mimic sleep disorders, such as cataplexy - the pathognomonic symptom of narcolepsy type 1 (NT1). NT1 is defined by excessive daytime sleepiness, cataplexy, and orexin deficiency. We report a case of a 20-year-old woman with psychiatric comorbidities who presented with cataplexy-like episodes, hypersomnolence, and hypnagogic hallucinations. She was ultimately diagnosed with FND mimicking narcolepsy, sometimes referred to as “pseudo-narcolepsy.” The diagnosis of FND must be based on the presence of positive clinical signs. This report reviews the most relevant clinical features supporting the diagnosis of FND in this context. Accurate diagnosis and effective patient communication are essential for therapeutic success, as studies have shown that a clear explanation can significantly reduce symptom frequency and severity.