P046 The Utility of Maintenance of Wakefulness Test (MWT) in Paediatric Narcolepsy

INTRODUCTION: The Maintenance of Wakefulness Test (MWT) has been used as an objective measure of the ability to stay awake and can be used to assess effectiveness of treatment. There are no universally accepted guidelines for assessing effective treatment or driving readiness in adolescents with narcolepsy and there is only limited data published on the use of MWT in children. The purpose of this study is to present a single-centre experience recording the use of MWT in a paediatric series. METHODS: This study reviewed the charts of children with narcolepsy who had an MWT performed between April 2014-January 2022. Demographics, clinical characteristics, MWT findings, change in management and driving status were obtained. RESULTS: MWT-40 minute protocol was used on 12 children with narcolepsy (median age 16.38 years, range 15.92 – 18.97years), of which 9 (75%) had cataplexy and four (33%) were males. The MWT was used to assess response to treatment and driving suitability. Two (17%) fell asleep during the 4 wake-trials. The median mean sleep latency for all studies was 16.88 minutes (range 5.75-28 minutes). In these two patients, findings from the MWT resulted in changes in management. Eight obtained their learners-driver’s licence after the MWT: Five signed “driving contracts” with their physician. DISCUSSION: Our result suggests that the MWT has clinical usefulness in evaluating responses to treatment in adolescents with narcolepsy. Changes in management occurred in all patients who failed MWT. This test was used in half patients to help determine readiness for driving in this group.