Abstract
Streptococcal infection-induced narcolepsy is a rare neurological disorder that may be accompanied by severe psychiatric symptoms and social dysfunction. In this case, delayed diagnosis and treatment were followed by progressive symptom worsening, including marked cognitive decline. The report underscores the importance of considering infectious triggers in narcolepsy and the therapeutic dilemma in managing psychiatric comorbidities-wake-promoting agents may exacerbate psychosis, while antipsychotics risk tardive dyskinesia. Early recognition and individualized treatment are crucial to improving outcomes.