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Re: cataplexy without narcolepsy

Posted by MD with narcolepsy on December 19, 2000 at 09:48:14:

In Reply to: cataplexy without narcolepsy posted by Emrille on December 18, 2000 at 01:11:19:

Cataplexy is pathognomonic of narcolepsy. That is, you don't have to have cataplexy to have narcolepsy, but you do have narcolepsy if you have cataplexy. 100% of cataplectics have narcolepsy!!!!!!

The Exception: I have read most scientific articles published on narcolepsy/cataplexy, and I did find a few (less than 3 or 4 cases worldwide) where patients apparently had developed cataplexy following some kind of trauma to head with damaged a specific part of the brain. Right now I can't recall the part of the brain which was reportedly damaged but it was similar in all (3-4) of these cases. Again, these pts 'apparently' had cataplexy and a couple had also acquired other, more severe forms of brain damage that left them in pretty bad shape. SO.......

Before anyone considers themself the exception to the rule that 100% of cataplectics have narcolepsy, it is important to recall how this disorder typically develops and progresses. We're not born with the symptoms. The excessive daytime sleepiness and uncontrolled sleep attacks start usually around 15 years of age and the cataplexy usually starts a few months-yrs LATER. Also, cataplexy usually starts out mild (only the head & mouth are involved) and usually takes 5-6 yrs to progress to total body paralysis during an attack. KEEP IN MIND THIS IS THE GENERAL PATTERN OF PROGRESSION.

After meeting alot of narcoleptics personally, I learned two important things:
1. Except for narcolepsy, had very little else in common
2. Even though we all have narcolepsy, we were all affected in very different ways. For example, the most bothersome and limiting symptom for me was the uncontrollable sleep attacks. However, there was a schoolteacher there who said, by far the worst symptom for her was the cataplectic attacks; every time she got excited she fell down in front of the students. Also, another man there was bothered mostly be automatic behaviors (he nodded in church one time and hallucinated that he had gotten up to walk up to where the choir was standing and 'awoke' to find that he was actually standing beside the choir with everyone staring at him). My point here is that the severity of the symptoms of narcolepsy are ordered differently depending on our personalities and lifestyles.

As a doc, I wonder: how old is your friend? has the attack happened before? if so, has it gotten worse? what is it like? what precipitates the attack? what other problems are going on in her life (other narolepsy symptoms?)? Has she used any drugs illicitly that she feels may be temporally associated with these attacks? do any family members have similar symptoms? Have family or friends witnessed these 'attacks'? if so, how did the witnesses describe the attacks (tip: a seizure can look like anything)?


Your friend should get checked out by a physician, and describe in detail what is happening to her.

Thanks

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