Secondary narcolepsy and cognitive dysfunction related to craniopharyngioma: a case study

BACKGROUND: Craniopharyngiomas, benign tumors of the sellar region, frequently disrupt hypothalamic function, leading to endocrine and neurological sequelae, including sleep disorders. CASE PRESENTATION: This case highlights the diagnostic and therapeutic challenges of secondary narcolepsy in a 19-year-old woman with craniopharyngioma. The patient presented with excessive daytime sleepiness, prolonged sleep duration, no cataplexy, and cognitive dysfunction following tumor treatment. However, CSF level of orexin/hypocretin was not measured. Diagnosis of secondary narcolepsy was confirmed through overnight polysomnography and multiple sleep latency tests. Combining methylphenidate for wakefulness and donepezil for cognitive support led to symptomatic improvement. CONCLUSIONS: This case underscores the necessity of recognizing secondary narcolepsy in patients with hypothalamic dysfunction and tailoring multidisciplinary management strategies to optimize outcomes.