Cataplexy laughter12/4/2023 ![]() ![]() Cataplexy is incapacitating because it leaves the individual awake but temporarily either fully or partially paralyzed. Novel and experimental treatments to manage cataplexy are required, including orexin replacement therapy and immune-based therapiesĬataplexy is the pathognomonic symptom of narcolepsy, and is the sudden uncontrollable onset of skeletal muscle paralysis or weakness during wakefulness. Γ-Hydroxybutyrate (GHB) and antidepressants are effective treatments for cataplexy, but most treatments (excluding GHB) are used 'off-label' Reduced noradrenergic and increased inhibitory input to motor neurons causes muscle weakness or paralysis during cataplexy positive emotions trigger cataplexy through neuronal pathways in the amygdala and medial prefrontal cortex The pathogenesis of cataplexy in human narcolepsy involves degeneration of orexin neurons in the hypothalamus genetically induced orexin deficiency causes cataplexy in both mice and dogsĬataplexy is thought to result from activation during wakefulness of the sleep circuitry involved in rapid eye movement sleep Individual may sleep for a few minutes, particularly if they are in an awkward position, or for a few hours if they are lying down.Cataplexy is the pathognomonic symptom of narcolepsy, and is characterized by sudden involuntary loss of skeletal muscle tone during wakefulness, typically triggered by strong positive emotions Periods of drowsiness may occur every three or four hours and usually end in short naps. Either of these symptoms can occur during the process of going to sleep or waking up, while the brain is partially asleep and partially awake. Sleep paralysis or temporary inability to move. Hypnagogic hallucinations. These are vivid, realistic, often frightening dreams. These attacks may last from a few seconds up to thirty minutes. ![]() The cataplectic attack may involve only a slight feeling of weakness and limp muscles (such as sagging facial muscles, a nodding head, buckling knees, loss of arm strength, garbled speech) but it also may result in immediate total body collapse, during which the person may appear unconscious, but remains awake and alert. Cataplexy occurs more frequently during times of stress or fatigue. Individuals often underestimate the duration of their drowsy periods and may not recall clearly their behavior during that time.Ĭataplexy. This is a sudden loss of voluntary muscle control, usually triggered by emotions such as laughter, surprise, fear or anger. In fact, narcolepsy is sometimes defined as the loss of boundaries between wakefulness, non-REM sleep, and REM sleep. REM (rapid eye movement) sleep is abnormal in narcolepsy. Periodic leg movements during sleep (periodic limb movement disorder). “Microsleep” episodes, in which the patient behaves automatically but without conscious awareness.Ī sense of paralysis that occurs between wakefulness and sleep (called atonia).ĭream-like states between waking and sleeping (called hypnagogic hallucinations). These events may be characterized by the following behaviors: Some, but not all patients experience other symptomsĮxcessive Sleepiness. All people with narcolepsy experience excessive sleepiness during the day with episodes of falling asleep rapidly and inappropriately, even when fully involved in an activity. Temporary and sudden muscle weakness (called cataplexy), usually brought on by strong emotions. The two primary symptoms in narcolepsy reflect this phrase:Įxcessive daytime sleepiness, with frequent daily sleep attacks or a need to take several naps during the day. The word narcolepsy comes from two Greek words that can be roughly translated as seized by numbness. This neurological disorder affects the control of sleep and wakefulness, causing excessive daytime sleepiness and uncontrollable episodes of falling asleep during normal waking hours.
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