[Narcolepsy--undiagnosed for 23 years].

A 43-year-old man had suffered from recurrent episodes of unconsciousness over twenty-three years. No definite diagnosis was forthcoming from numerous hospital stays and diagnostic work-ups, including three cardiac catheterizations which demonstrated severe aortic stenosis. Valve replacement, carried out on the assumption of aortic stenosis-induced syncopes, confirmed the aortic stenosis but the episodes of unconsciousness recurred and were now attributed to psychosomatic cardiovascular disturbances and hypochondria. Narcolepsy was diagnosed only during the 22nd hospital stay - not by further technical diagnostic procedures but by careful study of the history.