Narcolepsy: A Brief Critical Review and Study of Eight Cases

Most of the classical reviews of narcolepsy were written in the decade from 1925 (Kinnier Wilson, 1928; Redlich, 1931; Thiele and Bernhardt, 1933; Daniels, 1934, and others). The clinical picture was well established by these writers and does not need discussion. In addition to narcoleptic seizures, other symptoms are common, the most frequent being attacks of loss of tone and power, variously called cataplexy, “Lachschlag,” “Tonusverlust.” Night sleep is often disturbed by periods of wakefulness and bad dreams. During the phases of going to sleep or waking up, temporary paralysis of the muscles, without disturbance of consciousness, and hallucinatory episodes of all sense modalities sometimes occur. The generally accepted explanation of these various phenomena is that they represent a dissociation of the motor, sensory and central components of sleep. There are, however, three controversial points: firstly, the relationship of the patho-physiology of the seizures to epilepsy; secondly, the “somatic constitution “of the narcoleptic patient; and thirdly, the nosological status of narcolepsy.