NS-09NARCOLEPSY AND BRAIN TUMORS: PRESENTATION AND EVOLUTION
Bibliographic record
Abstract
We report an unusual case of an 11 year-old girl presenting narcolepsy in addition to growth failure and behavioral changes related to a large sellar and suprasellar germinoma. We aim to determine the clinical presentation and evolution of narcolepsy associated with brain tumors. METHODS: An extensive review of the literature was conducted to extract cases of narcolepsy associated with hypothalamic region brain tumors. RESULTS: A total of 24 cases were found in the literature, including 16 (67%) in children. Most patients developed narcolepsy after surgery, whereas 9/21 (42%) presented with narcolepsy prior to diagnosis. Most cases were secondary to craniopharyngioma (7/20, 35%), followed by glioma and adenoma (5/20, 25%). Only one patient had a germinoma and became symptomatic after surgery. Postoperative evolution was reported in fourteen patients. Two had a complete resolution of symptoms after treatment. Both patients were treated with biopsy and adjuvant therapy. For patients with persistent symptoms, most (70%) improved following medical management of narcolepsy. DISCUSSION: We present a unique case of narcolepsy related to a large germinoma. Although narcolepsy appears to be a rare complication of pediatric brain tumors with hypothalamic involvement, this peculiar condition might be under recognized and underreported. Most cases are secondary to surgically-induced damage to the hypothalamus. Patients that did not require extensive surgical resection appear to have a better outcome of narcolepsy symptoms. This study supports the importance hypothalamic-sparing and minimally invasive surgery for patients who response well to chemotherapy, since symptoms such as narcolepsy can resolve after tumor treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".