MRI findings in narcolepsy

Sleep. 1997 Aug;20(8):630-1. doi: 10.1093/sleep/20.8.630.


The neuropathology of narcolepsy is unknown. Recently, Plazzi et al. (1) reported magnetic resonance imaging (MRI) abnormalities in the pontine tegmentum of three patients with long-standing idiopathic narcolepsy. Considering the localization of the neuroradiological findings in the pontine reticular formation, where rapid eye movement (REM) sleep is generated, the authors suggested a causal relationship between narcolepsy and MRI abnormalities. Frey and Heiserman, however, found pontine MRI abnormalities in only two of 12 patients with narcolepsy both of whom had long-standing hypertension (2). Pullicino et al. noted similar pontine MRI abnormalities in patients with subcortical arteriosclerotic encephalopathy-like ischemic rarefaction of the pons (3). Thus, the changes noted by Plazzi et al. may have been caused by small-vessel disease rather than narcolepsy. To assess whether altered pontine MRI signals are a regular feature of idiopathic narcolepsy, we selected randomly from our database seven patients with narcolepsy with cataplexy. Of these seven, three agreed to have brain MRIs; their cases are described below. None had pontine MRI abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arteriosclerosis / pathology
  • Brain Ischemia / pathology
  • Central Nervous System Stimulants / therapeutic use
  • Female
  • HLA-DR2 Antigen / immunology
  • Humans
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Narcolepsy / diagnosis*
  • Narcolepsy / immunology
  • Pons / blood supply
  • Pons / pathology
  • Positive-Pressure Respiration
  • Reticular Formation
  • Sleep Apnea Syndromes / therapy
  • Sleep, REM*


  • Central Nervous System Stimulants
  • HLA-DR2 Antigen