Studies in Epilepsy: Personality Pattern, Situational Stress, and the Symptoms of Narcolepsy

THK term, "narcolepsy" was introduced in 1880 by Gelineau to describe a "rare neurosis characterized by an invincible need for sleep, ordinarily of short duration, occurring at longer or shorter intervals of time, often several times a day, forcing the subject to fall to the ground, or lie down in order to avoid falling" (9). Reports by others pointed out that, in addition to the attacks of sleep, patients sometimes fell, without disturbance of consciousness, as a result of sudden loss of muscle tone which appeared during a spontaneous burst of emotion, usually associated with vigorous laughter. This sudden loss of muscle tone, called "cataplexy," is sometimes found in persons who have never had an attack of sleep and the contrary is equally true. The one term "narcolepsy" now has come to include both varieties of symptoms. Disorders of sleep aroused widespread interest following the war of 1914-1918 during the epidemic of encephalitis, called "sleeping sickness." The existence of narcolepsy as a disease sui generis was called into question because of its frequent association with encephalitis and by the fact that neoplastic and other lesions as well were, presumably by their effect on an ill-defined "sleep-center," also associated with disturbances of sleep. Hence, as with epilepsy, the question of "genuine" and of "symptomatic" varieties of the "disease" arose. Since the daily life pattern includes the sleep-wakefulness cycle, recent investigators have been concerned with the connection between life situation stress, emotional problems, and excessive sleeping. If behavior, including the narcoleptic reaction, is viewed as a response of the organism to the environmental situation, all attacks are both "genuine" and "symptomatic."