In 1880 Gélineau proposed the name "narcolepsy" for a disorder whose outstanding characteristic is persistent and excessive sleepiness. Traditionally this disease has been regarded as a neurologic curiosity, infrequently diagnosed and poorly understood. In recent years increasing interest has led to a better understanding of the nature of this disorder and to prompter recognition of it.
This malady should interest internists since the majority of patients either present themselves to their family physician or are referred to internists for diagnostic evaluation. The referring physician may fail to grasp the significance of the excessive sleepiness, or patients may so word their complaints as to suggest a systemic disease. For these reasons internists should be familiar with the nature of this syndrome and its diverse manifestations.
With this in mind, let us review the nature of the narcoleptic syndrome.1 The narcoleptic tetrad consists of these symptoms: (1) abnormal sleepiness or narcolepsy
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