Narcolepsy research: past, present, and future perspectives.

Abstract

In 1877, Westphal described a patient with hypersomnia and episodic muscle weakness. He did not feel that these weakness attacks could simply be explained by "epileptoid" phenomenon. The next year, Fischer described a similar case. By 1880, Gélineau decided that patients with these symptoms represented a distinct clinical entity and he called it "narcolepsy". In 1902, Loewenfeld noted the importance of cataplexy in this disorder, and in 1934 Daniels published an important review on the topic which helped to galvanize interest in further study. In 1957, Yoss and Daly discussed the "clinical tetrad" which included hypersomnia, cataplexy, hypnagogic hallucinations, and sleep paralysis. In 1960, Vogel noted that patients with narcolepsy had early onset of REM sleep on their electroencephalograms. At the First International Symposium on Narcolepsy in 1975, the symptom of disturbed nocturnal sleep was added to the clinical diagnostic criteria for narcolepsy. For many years the etiology and mechanisms of this disease were poorly understood. It was not until the early 1970s when the exciting animal and human research first started to unravel the mysteries of the genetics and physiology of narcolepsy. This research will be discussed below.