Cataplexy

Cataplexy Definition

Cataplexy is a strange neurologic situation, which is sometimes confused with epilepsy.

Cataplexy often affects people who have narcolepsy, a disorder in which there is great difficulty remaining awake during the daytime.

The word cataplexy means, "to strike down." It happens in narcolepsy patients who describe it as sudden attacks of muscle weakness. It usually affects both sides of the body. It often happens because of strong emotions.  

These patients experience sudden loss of muscle tone and falls down at moments of strong emotion such as stress, laughter, anger or frightening experiences. Sending electric signals through the muscles and gauging their response can measure the phenomenon. People with cataplexy may injure themselves.

Cataplexy requires separate treatment from narcolepsy. Often, Imipramine or Desipramine can completely control this situation, when given in gradually increasing doses.

Cataplexy Causes

Depending on the severity of the attack, the episodes of muscular weakness show up as anything from a hardly noticeable slackening of the facial muscles to the dropping of the jaw or head, weakness at the knees, or total collapse on the floor.

Speech is slurred; eyesight weakened, but hearing and awareness remain undisturbed. These attacks are triggered by strong emotions such as excitement and laughter, anger and surprise.

Cataplexy may be most severe when the subject is tired rather than completely alert and can lead to considerable anxiety although anxiety itself is not a trigger. The attacks last some minutes and may end in continuation of normal behavior or the sufferer may slip into sleep sometimes of extended duration.

Cataplexy Symptoms:

With the help of unexpected and sudden loss of skeletal muscle tone (weakness or paralysis), cataplexy can be categorized. It is extremely unpredictable both in severity and frequency. Cataplexy may occur occasionally but may occur many times a day.

Muscle tone loss varies from mild to severe. The usual duration is from a few seconds to several minutes. Cataplexy may be partial or complete, affecting a range of muscle groups, from those controlling facial features to (less commonly) those controlling the entire body.

• Arm weakness
• Sagging jaw
• Drooping head
• Slumping of the shoulders
• Slurred speech
• Generalized weakness
• Knee buckling

Essentially, cataplexy is a symptom only found in narcolepsy and therefore, the presence of cataplexy makes narcolepsy diagnosis much more certain. Easily overlooked and frequently undiagnosed, cataplexy may affect the most basic activities of daily living.

By impairing primary functions like talking, eating, standing, walking, or driving, it can prevent patients from experiencing important activities such as holding a child, going to a movie, interviewing for a job, attending a party, participating in a meeting, or working out at the gym.

Even mild to moderate cataplexy symptoms or the fear of those symptoms can bound activities.

Symptoms cause humiliation and loss of self-esteem, leading to less social interaction, difficulty with interpersonal relationships, and depression. Symptoms of narcolepsy, including cataplexy, have been shown to have a severe impact on quality of life.

Cataplexy Treatment:

There is no cure for narcolepsy, but treatment focuses on controlling its symptoms. Excessive daytime sleepiness is treated with central nervous system (CNS) stimulants and wake-promoting agents.

The symptoms of cataplexy have been often suppressed with the help of Tricyclic antidepressants and selective serotonin reuptake inhibitors, although they are not approved for this indication. Xyrem is the first and only FDA-approved product for the cataplexy treatment related with narcolepsy.