Hypocretin Deficiency Develops During Onset of Human Narcolepsy with Cataplexy

STUDY OBJECTIVES: Although hypothesized through animal studies, a temporal and causal association between hypocretin deficiency and the onset of narcolepsy with cataplexy (NC) has never been proven in humans. SETTING: Paediatric Department, Blekinge Hospital, Sweden, and Danish Center for Sleep Medicine, Glostrup Hospital, Denmark. PATIENT AND RESULTS: Two weeks after his second Pandemrix-vaccination, a 10 year old HLA-DQB1*0602-positive boy developed NC. The CSF hypocretin-1 level was 10 pg/ml. However, CSF saved from a pre-narcolepsy episode of Lyme disease revealed a normal hypocretin-1 level (318 pg/ml). CONCLUSIONS: We confirm that hypocretin deficiency develops in parallel to the onset of human narcolepsy with cataplexy.