It’s also important to consider your daytime activities and how they impact upon your sleep. Things like going to bed at the same time each night and getting up at the same time every day are a priority. As such, you should always try to have good sleep hygiene. Lifestyle changes are an important part of managing symptoms and there is a link between sleep deprivation and cataplectic attacks. Whenever you’re out and about, you should be vigilant of any terrain or objects that might harm you if you were to fall. This might mean making time for naps to deal with the narcolepsy side of things, for instance. It’s important that all of your relatives and close friends know how to spot cataplexy and what to do if an attack occurs.Īt work or school, you should talk to your employer or school administrator so that they can make provision for your condition. If you plan activities like climbing or swimming, you should take extra precautions and not be alone. It’s a good idea to create safe areas in places you spend a lot of time in, i.e., your home and at work. This means you can deal with it safely and sit or lie down. When you’ve had a few cataplectic episodes, you will begin to know when an attack is coming on. There’ll also be a discussion and interview with the patient to try and ascertain what triggers the cataplectic events and which parts of the body are affected. Many patients choose to try and film episodes of cataplexy to show a doctor. Finally, a patient might undergo a lumbar puncture to draw out cerebrospinal fluid (CSF) from around the brain and spinal cord to test hypocretin levels.Ī diagnosis of cataplexy will often come with a diagnosis of type 1 narcolepsy.ĭiagnosing cataplexy alone is more of a challenge as there is no specific test. There might also be written evaluations like the Epworth Sleepiness Scale and the Stanford Narcolepsy Questionnaire as well as sleep studies (a polysomnogram) to record what happens in the brain and to the muscles during sleep. This is in order to make sure the symptoms are not caused by anything else. This often means taking short, space-out naps to see how quickly a person falls asleep.ĭoctors will typically do a full physical exam and assess a person’s health overall. There is often a multiple sleep latency test conducted to quantify how sleepy a person is during the day. For narcolepsy to be diagnosed, the patient usually needs to have excessive sleepiness during the day, hypnagogic hallucinations, and sleep-onset paralysis. When cataplexy isn’t related to narcolepsy, it could be caused by a number of other rare diseases and conditions.ĭiagnosing cataplexy is typically done by examining symptoms for narcolepsy. Though we don’t yet fully understand the genetic links between cataplexy and narcolepsy, around one in 10 people who have narcolepsy (type 1) will also have a close family member who has similar symptoms.Īnother causal factor is a brain injury, an acquired brain disease or a brain tumour. For this reason, it’s extremely rare to experience cataplexy without also having narcolepsy. This is known for regulating arousal and plays a part in transitions between wakefulness and sleep. Hypothalamic neurons produce a substance called hypocretin (otherwise known as orexin). With an autoimmune condition, the body attacks healthy cells, in this case the cells that produce hypocretin. Though there are continuing studies into the cause of cataplexy, the majority of people who have the condition have fewer hypothalamic neurons in their brains, likely caused by an autoimmune condition. The term was first used in late 19th-century German physiology to describe tonic immobility, which is also known as ‘playing possum’ due to the witnessed playing-dead behaviour of possums. Typically, an episode will resolve on its own after a few minutes. Unlike seizures or fainting episodes, which also cause tonic immobility, a person who experiences cataplexy will remain aware and conscious throughout the episode. Often, eyesight will become impaired (poor focus or double vision) and speech might be slurred. More often, an episode of cataplexy will be triggered by positive emotions, but negative emotions can occasionally be a trigger too.ĭuring a cataplexy episode, the person might collapse totally on the floor or they might feel slightly weak in part of their body. It is triggered by a strong emotion like surprise, anger, laughter, crying, or fear. Cataplexy, from the Greek ‘kata’ and ‘plexis’, meaning ‘down’ and ‘strike’ respectively, is a sudden episode of weakness combined with full awareness and consciousness.
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