ABSTRACT
Most cases of narcolepsy are caused by abnormalities of the hypocretin (Hcrt) system. Human narcolepsy is most likely due to postnatal degeneration of Hcrt cells through an inflammatory process. The most reasonable hypothesis explaining Hcrt cell loss is that it is immune system mediated. Intravenous administration of Hcrt can reverse the symptoms of narcolepsy. Variability in symptom expression among human narcoleptics, and even among animal mutant narcoleptics, remains to be fully explained and most likely involves interactions between Hcrt neurons and brain aminergic and amino acid systems.
