The antibodies bound to the hypocretin receptors, suggesting they may also latch onto these receptors in people and cause degeneration of the hypocretin system in the brain and, therefore, narcolepsy. They used antibodies from Finnish patients who had developed narcolepsy following Pandemrix vaccination, and added them to cells that were engineered to have a human hypocretin receptor on its surface. Scientists found a part of the H1N1 virus that resembled the hypocretin receptor. There were a number of dead ends, and one paper had to be retracted due to failure to replicate initial lab findings, but last month major progress was made. Baron Constantin von Economo, his life and work This led to a flurry of activity to try to identify diagnostic blood factors for narcolepsy, as well as proteins responsible for this side effect.Д¬onstantin von Economo identified narcolepsy among encephalitis lethargica sufferers. Recently, 1,300 cases of classical narcolepsy were observed in people who were given GSKвЂ™s Pandemrix H1N1 flu vaccine (out of a total of 30 million Europeans given the vaccine). The irony of this scene never left me вЂ“ and itвЂ™s probably a very good way to understand how someone with narcolepsy feels. Some years before his death, along with a number of others, I had dinner with a very jetlagged Honda, who exhibited frequent micro sleeps during the main course. Other researchers in Europe and North America confirmed these findings. In 1984, the late Yutaka Honda identified that 100% of his patients with classic narcolepsy had a particular type of HLA gene, in contrast to 25% of the general population. One vulnerability factor is a group of genes, called HLA genes, that determine immune responses. These historic findings have led researchers over the years to believe that narcolepsy has an environmental trigger in people susceptible to the condition. They also had lesions in the areas of the brain now known to contain the вЂњsleep switchвЂќ. He observed that victims of the mysterious encephalitis lethargica epidemic that followed the H1N1 Spanish flu had either severe sleepiness or insomnia. People with narcolepsy fight an irrepressible need for sleep. A hundred years of sleepД«ut why do some people get such a selective neurodegeneration? To answer that question, we need to go back to World War I, when Austro-Hungarian flying ace Constantin von Economo was dragged out his precarious profession by his wealthy parents and pushed into the safer pursuit of neuropathology. In effect, narcolepsy is a highly selective degeneration of hypocretin neurones, which makes it very different to other brain degenerative disorders with more widespread effects, such as AlzheimerвЂ™s or ParkinsonвЂ™s diseases. In classic narcolepsy, thereвЂ™s a degeneration or complete loss of hypocretin neurones, while adjacent neurones with other neurotransmitters are preserved. A dominant part of the switch is a small cluster of brain cells containing the neurotransmitter hypocretin, which regulates appetite, wakefulness and arousal, and is also known as orexin. ItвЂ™s located predominantly in the lateral hypothalamus and adjacent brain areas. The вЂњsleep switchвЂќ is actually a complex brain system acting as master controller for all aspects and behaviours associated with sleep. Just as a faulty light switch results in a light flickering on and off, their sleep-wake transition is constantly going on and off. These days, itвЂ™s understood that people with classic narcolepsy have a faulty вЂњ sleep switchвЂќ. But only a few people have true partial narcolepsy, while many others may have sleepiness due to other causes. Some people are also described as having вЂњpartial narcolepsyвЂќ, when they have irrepressible sleepiness without any of these REM intrusive behaviours.

Essentially, itвЂ™s difficult for them to maintain wakefulness or sleep for consistent periods, so they have insomnia with constant micro-sleeps during the day.

Other intrusive REM phenomena common in narcolepsy include the inability to move immediately before falling asleep or on waking (sleep paralysis), or visual hallucinations caused by awake dreaming.Дespite the profound sleepiness and drive to sleep exhibited by people with narcolepsy, most would describe their night-time sleep as disturbed.

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