#POV You’re The Doctor (Neurology): Season 3, Episode 2

Answer: B – Narcolepsy

The patient most likely has developed Narcolepsy, a neuro disorder that causes a host of fatigue related symptoms. It usually pops up first in adolescence, but it can also come later in life as seen here. Patients with narcolepsy will show excess daytime sleepiness even with sufficient sleep, and it often occurs during inappropriate times (like working a crane). They may also find themselves suddenly weak in an arm or leg (cataplexy) or even with strange hallucinations as they’re falling asleep (hypnagogic hallucinations) as seen in this patient who sees ghosts as he’s falling asleep!

While daily exertion in a physically demanding job can cause fatigue, this patient appears to get enough sleep each night to recover, and it also wouldn’t explain the hallucinations (Answer A). A brain tumor, which can cause fatigue and altering levels of consciousness, would most likely also produce headaches, visual/focal deficits, or even behavior changes (Answer C). 

References:
Kim LJ, Coelho FM, Hirotsu C, et al. Frequencies and associations of narcolepsy-related symptoms: a cross-sectional study. J Clin Sleep Med. 2015; 11(12): p.1377-1384.

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[TheNinnyfee]

What I am most amazed about is that you listened to the patient long enough to know his job and sleeping hours.

[trialgoddess]

I recognized it as narcolepsy because I worked with a bailiff for a few years in a courtroom where I tried a lot of cases. He would talk about it openly and tell me about his medication management. It was probably one reason he was a bailiff instead of a road deputy, but he was the consummate professional, a gentleman and an excellent bailiff.

[Rednecknana]

I really enjoy seeing if I am correct in my “diagnosis” coming from family of RNs. 😊

[jessicawilson]

I'd say thank you for even considering it's not all in my head. This is a very basic symptom for a million conditions. A doctor that doesn't dismiss it is A++.

[technicoloryaya]

The problem with online diagnosis is that these are symptoms of so many other things than just the 3 that were shown. That's why an in person meeting with a good diagnostician and doctor is crucial. What if his is sleep apnea or chronic insomnia?

[lacystacychick]

I have narcolepsy with cateplexy . When I hallucinate its either right before or right after I wake up, it paralyzes me ... I feel pressed down like I can't move at all, I hear buzzing in my ears, , I can't breathe, , and then it releases me and I can wake up . That is technically the cateplexy side of narcolepsy . I am always tired ... the meds are so so ... I have vertigo too when I fight my sleep ... my hallucinations are usually spiders slowing stringing down from the ceiling or people that look like shadows with eyes ... dark figures . Its terrifying as fuck ... what terrifies me the most is I'm aware of my surroundings I'm in my bedroom during this dream state but those things are also with me and I can't get away from them .... had this since age 7 .... I'm 30 now .. I'm used to it but it still scares the hell out of me and people will look at you like your damn crazy when you talk about it but it's 100%%% real.

[HillbillyYEEHAA]

I have all the symptoms of narcolepsy but i don't transistor randomly fall asleep when stressed ect

[jsmillsi]

You can't even begin to make diagnosis with any of this information...

[dotexe]

Classic B1 Deficiency prescribe 300-600mg daily Benfotiamine along with a B complex perferably from nutritional yeast as well as a good mineral complex for mag, sodium, & potassium. B1 is key for mitochondria health. Anyone showing signs of extreme fatigue paired with anxiety or even nightmares needs more Thiamine.

[videorocketzmillarmilla]

❤❤ so far im getting them all correct. Excellent channel. Subscribed 🎉🎉🎉

[daveshondel]

Stage four Geoblastoma! Secondary diagnosis of C diff, with a probability of Sloppy flatulence and explosive diarrhea in formal settings. You’re welcome.

[jerrislittlereef]

I really like these video games so far.

[zeldafitzgerald]

Pov would mean the camera would be looking at the patient, not at you.

[theautodidacticman_]

Usually anyone with narcolepsy was a past abuser of some kind of drug.

[Jasper-sbkk]

B, however, I would order a heart stress test.

[domoloveswaffles]

I would say brain tumor.
If you think you're seeing ghosts and having conversations with them and speaking with them.
Remember izzy in season three? The. She gets a brain tumor?
That name that she had, her medical condition, could be apart of this

[swaliharukshana]

Google be like : brain tumor 99% terminal

[rubylady]

If he was a woman with those same symptoms, the diagnosis would be she is fat and over stressed and just needs to get some rest and calm down 😒