People living with epilepsy have seizures that occur again and again over time. At first glance, this brain disorder may seem completely different from what you know about narcolepsy. However, when you learn more about epilepsy, you may see how one of these conditions could sometimes be confused for the other.

If you suspect that you are living with epilepsy instead of narcolepsy, or that you should be diagnosed with one of these conditions, it’s important to understand how to tell them apart. Then, you can work with your neurologist to figure out what diagnosis and treatment is best for you.

What Is Epilepsy?

When a person lives with epilepsy, it means that there is sometimes unusual activity in their brain. It’s usually a large amount of electrical activity that happens quickly. This activity causes seizures. You might have an idea about what a seizure looks like from TV or movies. However, seizures can look very different depending on what part of the brain is affected and what type of unusual activity is going on in the brain.

In general, there are two types of seizures. Focal seizures involve electrical activity in only one area of the brain. Generalized seizures seem to indicate abnormal electrical activity that occurs throughout the brain.

Generalized seizures can show up in different ways. Some people shake in the way seizures are often shown on television: these are tonic-clonic seizures (formerly known as grand mal seizures). Others stare off into space (absence seizures), fall over (atonic seizures), become stiff (tonic seizures), or experience other symptoms.

Are Narcolepsy and Epilepsy Connected?

It’s not currently known if there is a connection between narcolepsy and epilepsy, or what that connection might be. There have been cases where they have occurred together, but researchers don’t know if they’re connected to the same brain activity or not.

There does seem to be a connection between sleep disorders and epilepsy. One 2024 study suggests that people with epilepsy might have a higher risk of developing narcolepsy than the rest of the population does. However, upon further evaluation, most of those at risk did not actually have narcolepsy. The study concludes that researchers need to do more work to figure out how sleep problems, including narcolepsy, might be related to epilepsy.

Similar Symptoms in Narcolepsy and Epilepsy

Narcolepsy and epilepsy sometimes share some symptoms. This can cause confusion and even incorrect diagnosis. Symptoms commonly associated with narcolepsy that may cause confusion with epilepsy include:

• Cataplexy — Powerful or strong emotions that cause sudden muscle weakness or loss of muscle control
• Excessive daytime sleepiness — The unshakeable struggle to stay awake during the day
• Automatic behaviors — Behaviors your brain performs without your full awareness

Of these, cataplexy may be the most difficult symptom when it comes to discovering a cause. If your muscles suddenly become weak or you have a sudden loss of muscle tone, it may look like you experienced an atonic seizure. On the other hand, to people more familiar with narcolepsy, a real atonic seizure can look like cataplexy, too.

You will need to work with a medical professional to figure out which disorder you’re actually living with, or if you’re living with both of them.

How To Tell the Difference Between Narcolepsy and Epilepsy

To determine the right diagnosis for you, your healthcare provider will probably begin by having a conversation. They will talk to you about what you’re going through and ask questions to understand what’s going on in your body. It’s fine if you can’t answer all of their questions. Sometimes, people don’t notice everything that’s happening, especially when they feel anxious or worried.

What your doctor decides to do next will probably depend on your diagnosis. You might have to do some or all of the tests listed below.

Epworth Sleepiness Scale

This straightforward test helps your doctor get an idea of how sleepy you are at different times of day. You’ll be asked simple questions about how likely you are to fall asleep at certain times or in certain situations.

Neurological Exam

A neurological exam tests your movement and brain function. It can highlight important characteristics that help your doctor determine whether you’re living with narcolepsy, epilepsy, or both.

Electroencephalogram

Electroencephalogram (EEG) monitors your brain waves to look for seizures. It can also find differences in your brain waves that are caused by seizures, even if you don’t experience one during the test.

During the test, you’ll have electrodes attached to your head. These may come in the form of a cap that you wear on your head. The electrodes track the electrical activity in your brain to help your doctors better understand what is happening in your brain. The test may include a video so the doctors can see what’s happening with your body if they see any unusual electrical activity. A high-density EEG is a similar test that uses more electrodes.

If doctors find evidence of unusual electrical activity, depending on your history, it’s possible you’ll be diagnosed with epilepsy.

Sleep Study

If doctors think you might be living with narcolepsy, they’ll likely recommend a sleep study. For this test, you’ll spend the night under medical care. The medical staff will monitor all sorts of metrics, including your brain activity, body movements, and heart and lung function. This helps them rule out possibilities like obstructive sleep apnea, which can cause daytime tiredness.

Multiple Sleep Latency Test

This test is key when it comes to diagnosing narcolepsy. It will be done at a sleep center during the day. The medical staff will have you fall asleep several times over the course of a day. They’ll track how fast you fall asleep and how quickly you enter into rapid eye movement (REM) sleep. Understanding these patterns will help them determine if you’re living with narcolepsy.

Imaging and Lumbar Puncture

Sometimes, your doctor might ask for a scan of your brain or a test to collect a tiny sample of the fluid around your spine. These tests can help in diagnosing epilepsy or narcolepsy.

Putting It All Together

After you complete all the tests your healthcare team requested, they will help you understand the results. They might diagnose you with narcolepsy, epilepsy, or both conditions. If you have any questions, make sure to ask them so you can get the information you need to find the right treatment for you.

If you’re diagnosed with either condition, the next step might be to figure out what type of narcolepsy or epilepsy you’re living with. They may also give you medical advice for how to stay safe and manage your condition at home while you’re waiting for treatments to work or trying to find the right one.

Treating Narcolepsy, Epilepsy, or Both Disorders Together

After you get diagnosed with narcolepsy, epilepsy, or both, you and your neurologist can work together to determine the best treatments for you. Usually, narcolepsy and epilepsy need different kinds of treatments. There are also many treatment options available for each condition.

If you have been diagnosed with both disorders, your neurology team will make sure that any treatment they suggest for one won’t make the other worse. They will also keep a close eye on you during follow-up visits to ensure the medication is helping and that you have fewer symptoms.

Find Your Team

MyNarcolepsyTeam is the social network for people with narcolepsy. On MyNarcolepsyTeam, more than 11,000 members come together to ask questions, give advice, and share their stories with others who understand life with narcolepsy.

Have you been diagnosed with narcolepsy, epilepsy, or both? How did you figure out what you were experiencing? Share your thoughts and experience in the comments below, or start a conversation by posting on your Activities page.