History of Narcolepsy

First and most compelling descriptions of narcolepsy were formally stated by Westphal in year 1877, and Fisher in year 1878 in Germany. The abnormal connection between muscle weakness occur by extreme sleepiness were proved in their two reports. For both cases, inheritance factors were claimed which the Westphal‘s patient’s mother also had narcolepsy, and same goes to Fisher’s patient where his patient’s sister also had narcolepsy.

The most reliable theory that explains narcolepsy symptoms at that time was refered by the Von Zastrow case. Von Zastrow was arrested raping and he is believed to suffer pathological sleepiness caused by his excessive masturbation.

In year 1880, Gelineau, who were popularly known for giving the name of this disorder as “narcolepsy”, is also the one who found the specific entity clinical of narcolepsy.  His description did not really differentiate sleep attacks and muscle weakness occurs by emotions. In fact, he suggested a usual physiology for sleep attack and muscle weakness symptoms. Loewenfeld is the one who gives “cataplexy” name to the muscle weakness symptom in year 1902.

In proposing a treatment for narcolepsy, various methods were used. This includes cerebrospinal fluid removal, intrathecal injection of air, and X-ray irradiation. Ephedrine treatment was also used as an effective treatment of sleepiness during the daytime until Bloomberg and Prinzmetal founded amphetamines in year 1935. In 1960s, methylphenidates were introduced by Daly and Yoss. Right after the introduction of tricyclic antidepressants in year 1957, Takahashi, Akimoto and Honda introduced imipramine as the treatment of cataplexy. Until today, anti depressant and dual stimulant were mostly used for people wit narcolepsy.

Early pictorial account of rapid eye movement (REM) sleep leads researcher to research about the narcolepsy sleep onset. In year 1960, Vogel report a rapid eye movement sleep on patient and his observation were continued by Dement and Rechschaffen years later.
With all those observation and research, it was found that rapid eye movement sleep explain a few symptoms of narcolepsy. It also led them to establish the multiple sleep tests as standard test for narcolepsy symptoms. Because of this great observation progress, Daniels and Kleitman, believed that narcolepsy is actually an organic disorder that consists of abnormal stimulation reflexes.

Observations that stated human narcolepsy actually associate with the lack of hypocetin levels drives to the diagnostic perspectives. A standard diagnostic procedure is to measure the hypocretin levels. Using current technology, levels of hypocretin cannot be detected in plasma. However, receptors and hypocretin in the gut shoes that the low levels are circulating in the periphery. Thus, it is possible to see the analogues to supplement a hypocretin.

The exact and main factors that cause narcolepsy are still unknown. But there are many factors that might combine as factors to the lacking of hypocretin, the brain chemical that promotes wakefulness. Narcolepsy was diagnosed by family background, sleep test, and symptoms. It is clear that there’s still no cure for narcolepsy found, but it can improves with the changes in lifestyle and prescribed medicine.