Successful management of cataplexy with intravenous immunoglobulins at narcolepsy onset

Authors

  • Yves Dauvilliers MD,

    Corresponding author
    1. Service de Neurologie B, Hôpital Gui-de-Chauliac, Montpellier, France
    2. Biochemistry and Genetics, Department of Psychiatry, Geneva University Hospitals, Chêne-Bourg, Switzerland
    3. Institut National de la Sante et de la Recherche Médicale E0361, La Colombière Hospital, France
    • Service de Neurologie B, 80, avenue Augustin Fliche, Hôpital Gui-de-Chauliac, 34295 Montpellier Cedex 5, France
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  • Bertrand Carlander MD,

    1. Service de Neurologie B, Hôpital Gui-de-Chauliac, Montpellier, France
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  • François Rivier, MD, PhD,

    1. Service de Neuropédiatrie, Gui-de-Chauliac Hospital, Montpellier, France
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  • Jacques Touchon MD,

    1. Service de Neurologie B, Hôpital Gui-de-Chauliac, Montpellier, France
    2. Institut National de la Sante et de la Recherche Médicale E0361, La Colombière Hospital, France
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  • Mehdi Tafti PhD

    1. Biochemistry and Genetics, Department of Psychiatry, Geneva University Hospitals, Chêne-Bourg, Switzerland
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Abstract

Hypocretin/orexin deficiency appears to be a consistent feature of narcolepsy with a putative autoimmune mechanism involved. We treated four hypocretin/orexin-deficient narcolepsy patients with intravenous immunoglobulins and assessed the efficacy by repeated polysomnographies and questionnaires. Three patients received the treatment within a few months after acute onset of narcolepsy. A clear improvement in the frequency and severity of cataplexy was obtained with a benefic effect up to 7 months without any anticataplectics drugs at follow-up. Our findings point to the importance of early diagnosis of narcolepsy, which once treated quickly may modify its long-term outlook. Ann Neurol 2004;56:905–908

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