Moreover,clinical follow-up of adult patients with narcolepsy without cataplexy showed that 10%developed cataplexy many years after EDS onset.6 A slow appearance of NT1 symptoms together with a progressive decline ofCSF HCRT-1 from intermediate to low levels has been recently described in an adultpatient.7 However, the naturalhistory of hypocretin neuron loss and CSF HCRT-1 level reduction remains unclear. This evidence concerns the gene HCRT and Ehlers-Danlos syndrome.