Narcolepsy

Narcolepsy generally separated into two pathophysiological subtypes, including narcolepsy with or without cataplexy. When cataplexy is present, narcolepsy in humans is almost always caused by a deficiency of hypocretin, a neurotransmitter produced by 50,000-100,000 neurons located in the posterior hypothalamus. The occurrence of narcolepsy involves genetic predisposition and environmental triggers. Narcolepsy typically begins in adolescence and early adulthood, although late adult onset or onset in prepubertal children is described in approximately 10% of cases. The symptoms of narcolepsy are excessive daytime sleepiness (EDS), cataplexy, sleep paralysis, and hallucinations. The management and treatment of narcolepsy include life-modifying interventions and medications targeting the most disabling symptoms, typically EDS and cataplexy. Life-modifying interventions include scheduled napping for 20 minutes, once at noon and once in the later afternoon, to decrease EDS, minimizing the use of stimulants, and reducing the frequency and severity of cataplexy.