Respiration and electroencephalography in narcolepsy

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Abstract
The electro-encephalogram, the spirogram, and the alveolar carbon-dioxide tension were recorded continuously for periods of three to four hours in 4 cases of narcolepsy. The technic permitted a breath-by-breath analysis of respiratory changes and also a correlation of respiratory events with changes of the electroencephalogram during shifts in the level of wakefulness. Numerous spontaneous, typical, transient narcoleptic attacks of sudden imperative drowsiness and sleep were recorded in each patient. When awake, the patients showed a normal ventilation and alveolar carbon-dioxide tension. It was confirmed that narcoleptic attacks are accompanied by changes in the electroencephalogram similar to those in normal persons falling asleep. The respiratory changes during narcoleptic attacks also followed the pattern of normal sleep[long dash]that is, there was a ventilatory decrease and an increase in alveolar carbon-dioxide tension. However, the respiratory and electro-encephalographic changes during narcoleptic attacks took place more rapidly than in normal persons falling asleep. The findings demonstrate that in narcolepsy the close functional linkage is preserved between centers regulating the cortical state of excitability and those regulating respiration. It is assumed that a neuronal defect within these centers, probably situated within the reticular system of the brain stem, is primarily responsible for the acute narcoleptic attacks.