Isolated thyrotropin deficiency in a man with narcoleptic attacks.

A patient with narcoleptic attacks and isolated thyrotropin deficiency is presented. Substitution with l-thyroxine did not relieve his narcoleptic attacks. Deficiency, in the central nervous system, of the ergotropic substance thyrotropin-releasing hormone (TRH) might have caused the thyrotropin deficiency and contributed to the narcoleptic attacks. However, prolonged oral medication with TRH, in doses of 120 or 240 g daily, failed to attain any significant relief. Although this does Not exclude TRH unresponsiveness due to absent or defective TRH receptors, the true cause of the disease remains to be elucidated.