The History of Narcolepsy

Abstract

Today, narcolepsy is recognized as a disease of excessive sleepiness caused by dysfunctional rapid eye movement (REM) sleep mechanisms, which can occur with (or less often without) the clinically related REM sleep phenomena that include cataplexy, sleep paralysis, and hypnagogic hallucinations. Although there have been anecdotal reports of some aspects suggesting that the disorder can be traced back to antiquity, only recently has there been a significant scientific understanding concerning the pathophysiology of the disease. Carl Westphal first published a report of sleepiness and episodic muscle weakness in 1877; nevertheless, narcolepsy with cataplexy was clinically recognized as a distinct entity only in1880, by Jean Baptiste-Édouard Gélineau. Following the outbreak of encephalitis lethargica from 1915 to 1924, Constantine Freiherr von Economo hypothesized that the pathology behind the disorder localized to the rostral brainstem. In the early 1950s, Nathaniel Kleitman and Eugene Aserinsky discovered REMs during sleep, thus laying the groundwork for advancing the understanding of narcolepsy in the ensuing years. The subsequent animal models of narcolepsy, genetic research, and neurophysiological and neuroanatomical studies of the past several years have furthered our understanding not only of narcolepsy, but of sleep medicine as a whole. In this article, we shall follow the evolution of our understanding of narcolepsy from the folklore of ancient times to recent scientific advancements.