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Although symptomatic narcolepsy,or narcolepsy due to identifiable brain lesions,was once thought to be common,there are few well-documented reported cases since the discovery of the association of REM sleep abnormalities with narcolepsy.Even fewer such reports have been accompanied by human leukocyte antigen(HLA)testing.We report 3 patients who fulfill criteria for symptomatic narcolepsy,1 with a craniopharyngioma,the 2nd with a hypothalamic syndrome of unknown etiology,and the 3rd with obstructive hydrocephalus and a sarcoid granuloma in the region of the 3rd ventricle.The first 2 were positive for HLA-DR2 while the 3rd was negative for the HLA-DR2 and HLA-DQw1 antigens. These findings suggest that diencephalic lesions can be associated with signs and symptoms of narcolepsy that are clinically indistinguishable from those of idiopathic narcolepsy,and that the HLA-DR2 antigen is not required in all cases of symptomatic narcolepsy. |
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craniopharyngioma
HLA
hydrocephalus
hydrocephalus,non-communicating(obstructive)
hypothalamus,disturbance of
narcolepsy
sarcoidosis
sarcoidosis,CNS
third ventricle,mass of
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