Cataplexy: Diagnosis, Causes and Treatment

Cataplexy happens when solid emotions (like laughter, excitement, or anger) trigger sudden, brief strong weakness when you’re awake. It’s one of the main indications of narcolepsy. Narcolepsy is a persistent (long-lasting) sleep disorder that causes an urge to fall asleep abruptly amid the daytime that’s almost incomprehensible to resist. It affects children and grown-ups. Cataplexy is also an indication of certain exceptionally uncommon genetic conditions.

Weakness in muscles in cataplexy episodes can be measured from mild to severe. For example, you will have weakness in only a couple of muscles, like those in your face leading to a drooping jaw or mild head drop. In serious cases, you’ll lose total control of your muscles and collapse. However, individuals continuously stay conscious (awake) amid a cataplexy attack, not at like in fainting (syncope) and seizures. Attacks ordinarily last seconds to a couple of minutes and instantly go away on their own. The frequency of attacks varies. A few individuals have a few cataplexy attacks a day, while others may have them only a few times a year.

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Cataplexy Indications:

Cataplexy happens unexpectedly and without warning. A prominent symptom of cataplexy is that it does not affect one’s consciousness.
This could be a special characteristic that can separate cataplexy from a seizure, syncope (blacking out), or a psychiatric condition.
Cataplexy episodes may last for seconds at a time. The recurrence of episodes can vary, depending on the condition of whether it is treated or not.
Episodes of cataplexy can happen without a trigger, but they can moreover be preceded by emotional signs, such as laughing surprise, or extreme and quick changes in mood.

A cataplexy episode can have the following indication when it happens:

1. Leaning your neck over
2. Suddenly dropping your body
3. Dropping something
4. Falling to the ground

Cataplexy is frequently mistaken for a seizure when it’s more extreme. But unlike a seizure, you’ll likely stay conscious and remember everything that happens amid an episode. Cataplectic episodes moreover vary in length. They may last only a couple of seconds or go on for up to a couple of minutes. Cataplexy ordinarily happens after you feel a solid emotion.

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Emotional triggers can include:

1. excitement
2. happiness
3. stress
4. fear
5. outrage
6. chuckling

Not everyone with cataplexy has the same triggers. They may moreover not be steady. Chuckling may cause cataplexy in certain circumstances, but not others. Outrage may trigger an episode in one case, but not another. Cataplexy can be one of the primary recognizable indications. It frequently appears up as a minor muscle abnormality, such as your eyelid drooping or your head falling over briefly since your neck muscles weaken. As a result, you will not indeed realize you’ve got cataplexy or narcolepsy.

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How are cataplexy and narcolepsy related?

Narcolepsy is a chronic condition that causes episodes of overpowering daytime sleepiness and attacks of sudden sleep. Individuals who have narcolepsy have inconvenience in staying awake no matter what’s happening around them. A few individuals with narcolepsy also have a condition called cataplexy. Typically called type 1 narcolepsy. Cataplexy is distinguished by episodes of a sudden loss of muscle tone and control.These episodes are brief and frequently triggered by stress or other solid emotions. They can happen as once in a while as once a year or as regularly as a few times a day.

In some cases, cataplexy episodes are the primary symptom of narcolepsy and can offer assistance lead to a conclusion. But not everybody with narcolepsy encounters episodes of cataplexy, and not everybody who encounters cataplexy has narcolepsy.

What causes cataplexy?

In case you have got narcolepsy with cataplexy, your brain doesn’t have sufficient hypocretin (orexin). This brain chemical makes a difference keep you awake and controls your rapid eye movement (REM) sleep cycle. Other parts of your brain that control your sleep cycle are also thought to play a part in causing narcolepsy with cataplexy.
What causes cataplexy without narcolepsy, and who’s at chance?
Most individuals who encounter episodes of cataplexy have narcolepsy. But there are other causes and risk variables. These incorporate:

1. Niemann-Pick type C Disease (NPC): NPC is a hereditary condition that causes neurologic symptoms. Sometimes, this incorporates cataplexy.
2. Angelman Syndrome: Angelman syndrome is a hereditary condition that leads to developmental delays and intellectual inability. This will cause cataplexy.
3. Prader-Willi syndrome: Prader-Willi syndrome is a hereditary condition that can cause, or postpone growth, developmental delays, and nourishing challenges. A few children with this condition too have cataplexy.
4. Strokes and brain tumors: Strokes and brain tumors can harm the nervous system and can lead to cataplexy.
5. Certain medications: Cataplexy can be an impact of certain medications, but typically it is uncommon.

Diagnosis:

The diagnosis of cataplexy includes a medical history and a point-by-point evaluation of indications. Sudden loss of muscle tone can happen with several conditions that have to be ruled out before cataplexy is considered the cause. Other conditions that can cause falls or a loss of muscle tone may include:

1. Seizures, which more often than not incorporate loss of consciousness, which isn’t a characteristic of cataplexy
2. Syncope, which ordinarily includes dizziness or a feeling of lightheadedness, which are not features of cataplexy
3. Muscle weakness, which isn’t usually as abrupt and irregular as cataplexy
4. Hypoglycaemia (low blood sugar), which includes other indications, in addition to the loss of muscle tone
5. Psychiatric disturbance, which is ordinarily related with other indications, such as anxiety or hallucinations.
   Diagnostic tests that can be done to help distinguish the cause of cataplexy are generally facilitated by the associated signs and risk factors.

Tests may include:

Blood tests:

Measuring the glucose and electrolyte levels Hypocretin level within the cerebrospinal fluid: Is reduced in narcolepsy type 1

Electroencephalogram (EEG):

A brain wave test that recognizes signs of epilepsy Electrocardiogram (ECG or EKG): Records the electrical movement of the heart

Brain imaging:

Can identify evidence of brain harm or traumatic injuries.

Treatment

Treatment aims to decrease the frequency and seriousness of cataplectic attacks. Medicines commonly used for cataplexy include:

Sodium oxybate:

This medicine makes a difference in the progress of night-time sleep and decreases excessive daytime sleepiness.
Specific serotonin re-uptake inhibitors (SSRIs) and serotonin-norepinephrine re-uptake inhibitors (SNRIs):
These antidepressant medicines can offer assistance to control cataplexy symptoms by regulating neurotransmitter levels within the brain.

Tricyclic antidepressants:

These drugs are another choice for managing cataplexy symptoms.

Stimulants:

In some cases, healthcare experts may prescribe stimulant medicines to assist people remain awake and decrease daytime sleepiness.
In addition to medication, making lifestyle changes can moreover contribute to overseeing cataplexy:

Creating a secure environment:

Guarantee a secure environment amid cataplectic attacks, particularly when engaging in activities such as driving or operating machinery. Bosses, schools, and colleges should be mindful of individuals with cataplexy to supply vital accommodations and support.

Emotional support:

Cataplexy can lead to emotional trouble and depression. Family and companions ought to offer understanding, compassion, and support to people living with the condition.

Sleep hygiene:

It includes making a comfortable sleep environment and practicing relaxation methods before sleep time.

Regular workout and sound diet:

Engaging in standard physical workouts and keeping up a balanced diet can contribute way better by and large sleep quality.

Summary:

In cataplexy, there is a sudden episode of the loss of muscle control. Most individuals who encounter episodes of cataplexy too have narcolepsy. But not everybody who encounters cataplexy has narcolepsy. Cataplexy can also be a symptom of a few hereditary conditions or the result of a stroke or brain tumor. In some cases, it can be a side effect of certain drugs. Treatment depends on how frequent episodes happen but commonly incorporates antidepressant medications.

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While cataplexy isn’t ordinarily perilous specifically, it can create dangers in certain circumstances. It’s too a condition that can genuinely disturb your life. The great news is that cataplexy is treatable. Together, you and your healthcare provider can discover a treatment arrangement that works best for you.