3/22/2023 0 Comments Mild cataplexy![]() Attacks are brief, most lasting from a few seconds to a couple of minutes, and typically involve dropping of the jaw, neck weakness, and/or buckling of the knees. Signs and symptoms Ĭataplexy manifests itself as muscular weakness which may range from a barely perceptible slackening of the facial muscles to complete muscle paralysis with postural collapse. Even if he preferred the term 'astasia' instead of 'cataplexy' the case described by him remained iconic for the full narcoleptic syndrome. Nevertheless, the onset reported by him was in adulthood as compared to the nowadays cases reported in childhood and adolescence. In the same year the French neuropsychiatrist Jean-Baptiste Gélineau coined the term 'narcolepsy' and published some clinical reports that contain details about two patients who have similar condition as the narcoleptic cases nowadays. The term cataplexy originates from the Greek κατά ( kata, meaning "down"), and πλῆξις ( plēxis, meaning "strike") and it was first used around 1880 in German physiology literature to describe the phenomenon of tonic immobility also known as " playing possum" (in reference to the opossum's behavior of feigning death when threatened). Cataplexy without narcolepsy is rare and the cause is unknown. Cataplexy affects approximately 70% of people who have narcolepsy, and is caused by an autoimmune destruction of hypothalamic neurons that produce the neuropeptide hypocretin (also called orexin), which regulates arousal and has a role in stabilization of the transition between wake and sleep states. Her cataplexy quickly improved to only rare occurrences and K was able to engage with her clients with renewed confidence.Cataplexy is a sudden and transient episode of muscle weakness accompanied by full conscious awareness, typically triggered by emotions such as laughing, crying, or terror. Her cataplexy had improved somewhat but was still troublesome, so at her outpatient review a few weeks after the PSG it was decided to try her on a second medicine, this time for her cataplexy. She no longer struggled through the day and rarely needed to have a nap at work. After supervised dose adjustment she noticed a marked improvement in her level of alertness. K went home and started treatment the next day for her sleepiness. ![]() He confirmed that she had narcolepsy and explained that it was responsible for both her sleepiness and cataplexy. After the final study had been analysed she was met by a sleep specialist. She underwent a PSG and the next day had nap studies. She had begun to avoid interacting with customers and it had been commented to her boss that she had developed an aloof manner. On a number of occasions she had collapsed to the floor behind clients in the middle of doing their hair. K was also experiencing embarrassing symptoms of sudden leg weakness whenever she laughed (cataplexy). This was not an immediate problem, but she and her partner were hoping to start a family and she was worried that her sleepiness would make this impossible. On days off she would regularly sleep half the day away. It had reached the stage where she was falling asleep during work breaks, and sometimes needed rousing by her boss to return to her clients. Her sleepiness had developed over the previous 3 years. If symptoms such as cataplexy remain troublesome then separate drug treatment can be used, which again is effective and usually well tolerated.Ī 25-year-old hairdresser (K) went to her GP with the problem of increasing difficulty staying awake during the day. There are now effective medicines which increase alertness and are generally well tolerated. When daytime naps are not practical or sufficiently effective alone then drug treatment is considered. Some people with narcolepsy have only mild symptoms and are able to use regular naps during the day to avoid falling asleep when they need to stay awake. If referred to the RSSC you would typically be admitted overnight to our sleep laboratory for a sophisticated sleep study called a polysomnogram (PSG) and multiple sleep latency test (MSLT). If you regularly experience some or all of these symptoms then you should consult your GP about being referred to a sleep centre for further investigation. Sleep paralysis - a frightening feeling of paralysis upon waking from sleep.Hypnagogic & Hypnopompic hallucinations - dreams invading wakefulness.Cataplexy - sudden muscle weakness brought on by emotion ("conscious collapse").Awareness of it as a recognisable medical condition is fortunately increasing and there are now a handful of units in the UK, including the RSSC where people with suspected narcolepsy can be investigated and treated. Narcolepsy is a condition which affects 1 in 2-3,000 people but commonly goes undiagnosed for years.
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