Narcolepsy caused by ADEM

Gledhill RF, et al. Arch Neurol 2004; 61: 758-760.

Narcolepsy/cataplexy usually occurs sporadically in patients positive foo HLA DQB1*0602 with a loss of hypocretin/orexin in CSF, and is presumed autoimmune. However, it can also occur secondary to a lesion, in this case due to ADEM and partly responsive to steroids. In this case the lesion surrounded the third ventricle and hypothalamus and extended to the basal forebrain. The patient had sleep onset rem periods (SOREM) and cataplectic attacks.