Is this a cause for concern?
Cataplexy occurs when your muscles suddenly become limp or noticeably weaken without warning. You may experience cataplexy when you feel strong emotions or emotional feelings. This may include crying, laughing, or getting angry. You may find yourself falling over or losing control of your facial expressions.
Cataplexy is associated with narcolepsy. Narcolepsy is a neurological disorder that causes extreme daytime sleepiness. You may also fall asleep unexpectedly, even during a conversation or activity.
Other common symptoms of narcolepsy include:
- Feeling numb when falling asleep (sleep paralysis)
- Hallucinations before falling asleep (hypnotic hallucinations)
- Hallucinations when waking up in the middle of the night (hypnotic hallucinations)
However, only about 1 in 2,000 people worldwide suffer from narcolepsy, and cataplexy is even rarer. However, if you suddenly lose muscle control at the wrong time, such as during an important meeting, spending time with loved ones, or driving, the condition can disrupt your life and lead to complications.
What are the symptoms?
Symptoms of cataplexy may vary from person to person. Most people start noticing their symptoms when they are teenagers or young adults. This is usually when you enter college, the workforce, or other new, potentially stressful situations.
Some possible symptoms of a cataplexy episode include:
- drooping eyelids
- jaw dropped
- The head tilts to one side due to weak neck muscles
- Falling to the ground
- Twitching of various muscles around the body for no apparent reason
More severe cases of cataplexy are often mistaken for epileptic seizures. But unlike a seizure, you may remain awake and remember everything that happened during the seizure. Lengths also vary. They may last only a few seconds or last several minutes.
Cataplexy usually occurs after you feel strong emotions. Emotional triggers can include:
- Excited
- happiness
- pressure
- Fear
- anger
- laughter
Not everyone with cataplexy has the same triggers. They may also be inconsistent. In some cases, laughing may cause cataplexy, but in other cases not. Anger may trigger the plot in one situation but not another.
Cataplexy may be one of the first obvious symptoms in people with narcolepsy. It usually manifests as minor muscle abnormalities, such as drooping of your eyelids or a brief drop of your head due to weakened neck muscles. Therefore, you may not even realize you have cataplexy or narcolepsy.
What causes cataplexy?
Who is at risk for cataplexy?
Other risk factors and causes of narcolepsy with cataplexy include:
- Traumatic head or brain injury
- Tumors or growths near areas of the brain that control sleep
- Autoimmune disease, which may cause your immune system to attack brain cells that contain hypocretin
- Infections, such as swine flu (H1N1 virus), and H1N1 vaccine
If you have narcolepsy, you're likely to experience an episode of cataplexy at some point in your life. But not all people with narcolepsy experience symptoms of cataplexy.
How is cataplexy diagnosed?
If your doctor thinks you have cataplexy narcolepsy, they may recommend one or more of the following tests to diagnose you:
- Get a complete physical exam to assess your overall health and make sure your symptoms are not caused by another, potentially more serious condition
- Fill out a written assessment, such as the Stanford Narcolepsy Questionnaire or the Epworth Sleepiness Scale, to learn more about your sleep habits and find out how severe your narcolepsy symptoms are
- Take a sleep study (polysomnogram), which records changes in your muscles and brain while you sleep
- Take multiple sleep latency tests where you nap for several hours throughout the day to see how quickly you fall asleep during these naps
Your doctor may also remove fluid (cerebrospinal fluid) from around your spinal cord and brain. Your doctor can test this fluid for abnormal levels of hypocretin.
How is cataplexy treated?
Both cataplexy and narcolepsy can be treated with medications and lifestyle changes. Medications cannot cure narcolepsy or cataplexy, but they can help you manage your symptoms.
drug
Commonly used medications for cataplexy (with or without narcolepsy) include:
- Tricyclic antidepressants, such as clomipramine (Anafranil)
- Selective serotonin uptake re-inhibitors (SSRIs), another antidepressant such as fluoxetine (Prozac) or venlafaxine (Effexor XR)
- Sodium oxybate (Xyrem), which can help relieve daytime cataplexy and drowsiness
Medications used to treat cataplexy narcolepsy include:
- Modafinil (Provigil), which reduces drowsiness and helps you feel more alert
- Stimulants similar to amphetamines that keep you alert
Some of these drugs can have damaging side effects. These may include nervousness, abnormal heart rhythms, and mood changes. They are also at risk for addiction. If you are concerned about the effects of these drugs, talk to your doctor before taking them.
lifestyle changes
Certain lifestyle changes can make the symptoms of cataplexy and narcolepsy more tolerable.
Are there possible complications?
Symptoms of cataplexy and narcolepsy may occur without warning. If you are driving a car or operating machinery, the scenario can be dangerous or even fatal. Injuries can also occur if the attack occurs while you are doing activities involving high temperatures or dangerous objects. This can include cooking on the stove or using knives.
Knowing that emotions can trigger cataplexy episodes may allow you to avoid situations in which you know you will laugh, cry, or otherwise feel strong emotions.
Your friends, family, and romantic partners may not understand your condition. This can damage your friendships and relationships.
It may also be difficult to perform professionally if you have cataplexy episodes or feel sleepy at work.
Lower levels of hypocretin, along with certain lifestyle choices, can lead to weight gain and obesity. Obesity has its own complications, such as high blood pressure, stroke and heart disease.
What are the prospects?
Both cataplexy and narcolepsy can interfere with your daily life. It can put a strain on your intimate relationships and your professional life. But cataplexy can be controlled with treatment and lifestyle changes. Once it's under control, you can reduce your risk of having an attack while doing potentially dangerous things, such as driving.
If you begin to notice any symptoms of cataplexy, see your doctor for a diagnosis so you can begin treatment and manage the condition as early as possible.
Living with cataplexy
To make your life with cataplexy easier, here are some tips to remember:
- Tell all close friends and relatives that you have cataplexy and how to recognize the symptoms so they can better understand your condition and help you cope.
- Try to drive with someone else in the car, or let someone else drive as much as possible.
- Be aware of objects or terrain around you that could harm you if you fell, such as heights or sharp edges.
- Be prepared for situations that you know will cause strong emotions. If you need to sit down, move closer to a chair or go with a friend who can keep an eye on you.
- Try to get as much consistent sleep as possible - for example, take a nap in the afternoon and get eight hours of sleep at the same time every night.
