Narcolepsy and Cataplexy
Narcolepsy is a term suggested by Gélineau1 in 1880 to designate an uncontrollable desire for sleep resulting in a trancelike state of varying duration indistinguishable from normal sleep. This occurs under conditions not ordinarily conducive to normal sleep. Cataplexy is a term suggested by Henneberg2 to describe loss of muscle tone without loss of consciousness occurring in response to an emotional stimulus. This state is characterized by complete muscular atony, by absence of deep reflexes, and occasionally by a positive Babinski sign. The term cataplexy must be distinguished from the more common term catalepsy, which designates the state of muscular rigidity in the catatonic form of schizophrenia and in hysteria. The narcoleptic and the cataplectic syndromes may coexist in one person. Brock and Wiesel3 suggest that they are abnormalities of the two component parts of normal sleep: lack of mental awareness and sympathetic nervous relaxation.
Clinically, narcolepsy usually precedes cataplexy. A period of marked muscular weakness, such that the patient is unable to carry out voluntary motion, may occur either before or after the narcoleptic seizure. Both normal and narcoleptic sleeps in these patients may be accompanied by nightmares, sleepwalking, and sleeptalking.
The narcoleptic-cataplectic state appears in many respects to be merely an exaggeration of the normal reaction. Almost everyone has experienced sleepiness when listening to a dull, uninteresting lecture, and a sense of muscular weakness is exceedingly common under intense emotional strain.
Case 1. A man, aged 27, was first seen at the Clinic on August 14. . .