Terrie is a 33-year-old female who presents with the following symptoms: extreme drowsiness during the day, sudden loss of muscle tone that causes her head to fall forward and her knees to buckle. She also admitted to frequently falling asleep for short periods of time during the day and said she felt like she had no control over falling asleep. It "just happens." Upon questioning, she

acknowledged occasionally being in a "dreamlike state" where she experiences visual and auditory hallucinations. She had been admitting that because she was worried that she was psychotic or schizophrenic because of the hallucinations. Based on her symptoms and subsequent physical exam, EKG and EEG were ordered. Genetic testing was also ordered because narcolepsy was strong suspected. All tests, the genetic test in particular, were conclusive for narcolepsy. The patient was counseled about the disease and ways to manage it. She was started on an SNRI, venlafaxine, and Xyrem, which she is to use at night.

Dx: Narcolepsy with cataplexy

First-listed diagnosis: ________
Second-listed diagnoses: ________
Fill in the blank with correct word.

First-listed diagnosis: ________
Answer: Narcolepsy with cataplexy – G47.411

Second-listed diagnoses: ________
Answer: None