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Narcolepsy with cataplexy (NT1) and Multiple Sclerosis. UPDATE

  • Rosa Peraita-Adrados, MD, PhD, test
Submitted December 08, 2016

[I am an Author of this Work, and the Work was prepared on my own time - not as part of my duties as an employee.]

We read with great interest the article "Monozygotic twins discordant for narcolepsy Type 1 and Multiple Sclerosis (MS)," [1] a very well documented Case Report. Narcolepsy Type 1 (NT1) and comorbid immunopathological diseases or sporadic NT1 with MS have been reported in a few patients [2,3] and in one H1N1-vaccinated narcolepsy patient. [4] We agree with the authors that their Case Report is rare. For example, in 1966, familial cases in four families in which three family members had narcolepsy and multiple sclerosis was reported. [5]

The genetics of common complex autoimmune diseases are difficult to understand. Using NT1 and MS as an example, the susceptibility of these diseases results from the interaction of genes, the environment, and the gene and the environment. Potential associations between both diseases are relevant and might help to provide a better understanding of the implication of immune-related processes in the pathophysiology of both diseases.

1. Jennum PJ, Kornum BR, Gammeltoft S et al. Monozygotic twins discordant for Narcolepsy Type 1 and Multiple Sclerosis. Neurol Neuroimmunol Neuroinflamm 2016 Aug; 3(4), e 249.

2. Martinez-Orozco FJ, Vicario JL, Villalibre-Valderrey I, De Andres C, Fernandez-Arquero M, Peraita-Adrados R. Narcolepsy with cataplexy and comorbid immunopathological diseases. J Sleep Res 2014; 23:414-419.

3. Peraita-Adrados R, Lammers GJ, De Andres C, Santamaria J, Vicario JL, Tafti M. A patient with narcolepsy with cataplexy and multiple sclerosis: two different diseases that may share pathophysiologic mechanisms? Sleep Med 2013 Jul; 14(7):695-696.

4. Vrethem M, Malmgren K, Lindh J. A patient with both narcolepsy and multiple sclerosis in association with Pandemrix vaccination. J Neurol Sci 2012; 321:89-91.

5. Ekbom K. Familial multiple sclerosis associated with narcolepsy. Arch Neurol 1966:15:337-344.

For disclosures, please contact the editorial office at nnnjournal@neurology.org.

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