Narcolepsy is also known as narcoleptic syndrome, hypnolepsy, hypnopathy, Gélineau's syndrome, Gélineau's disease, paroxysmal sleep, and sleep epilepsy. The term narcolepsy comes from the Greek words narke (numbness) and lèpsis (attack, seizure). It translates loosely as 'somnolence seizure'. The eponyms Gélineau's syndrome and Gélineau's disease refer to the French neurologist Jean-Baptiste Edouard Gélin-eau (1828-1906), who introduced the term nar-colepsie in or shortly before 1880 to denote a neurological condition characterized by the compulsion to sleep for short durations at close intervals, and spells ofcataplexy. Descriptions ofnar-colepsy avant la lettre can be found in the literature dating back to ancient times. The first modern case reports of narcolepsy-cataplexy are commonly attributed to the German neurologist and psychiatrist Carl Friedrich Otto West-phal (1833-1890), although prior accounts were published by an author named Caffé in 1862, and by the German ophthalmologist Heinrich Bruno Schindler in 1829. Today the term narcolepsy is used to denote a neurological disease characterized by a variety ofsymptoms, including cataplexy, memory disturbances, * diplopia, strabismus, excessive daytime sleepiness, recurring *microsleep lapses, *sleep paralysis, and sleep-related hallucinations such as * hypnagogic and * hypnopompic hallucinations. The sleep attacks in narcolepsy typically have a sudden onset. They may occur at any moment of the day, even during one's engagement in potentially dangerous activities such as driving a motor vehicle. Elec-trophysiologically, these attacks are characterized by an immediate entry into the stage of REM sleep. Additional symptoms in narcolepsy include fragmented night sleep (i.e. insomnia), amnesic motor * automatisms, and * hallucinations proper, whichareoftenofa* visual nature. These visual hallucinations tend to be * complex in nature, although *compound hallucinations have also been reported, depicting scenes which are hardly distinguishable from sense perceptions. The lifetime prevalence of narcolepsy is estimated to be around 1 per 2,000 persons. Pathophysiolog-ically, narcolepsy is associated with an autoimmune process affecting the hypothalamus, which entails a reduction in the synthesis of hypocre-tin or orexin, a protein which plays a crucial role in the regulation of the sleep-wake cycle. Etiologically, this autoimmune process is associated with variations in the human leukocyte antigen (HLA) system, due to a chromosomal disorder affecting chromosome 6p21.3. Narcolepsy is usually classified as one of the dyssomnias. It tends to be treated with CNS stimulants such as methylphenidate or other amphetamines.
References
Aldrich, M.S. (1996). The clinical spectrum of narcolepsy and idiopathic hypersomnia. Neurology, 46, 393-401.
Gélineau, J. (1880a). De la narcolepsie. Gazette des Hôpitaux Civils et Militaires, 53, 626-628.
Gélineau, J. (1880b). De la narcolepsie. Gazette des Hôpitaux Civils et Militaires, 54, 635-637.
Szücs, A., Janszky, J., Hollo, A., Migléczi, G., Halâsz, P. (2003). Misleading hallucinations in unrecognized narcolepsy. Acta Psychiatrica Scandinavica, 108, 314-317.
Dictionary of Hallucinations. J.D. Blom. 2010.