12/7/2023 0 Comments Severe cataplexy attackThese children can easily be misdiagnosed with neurological conditions. “I thought I was just clumsy.” It took 26 years from symptom onset for Steiner to receive a correct diagnosis.īlack says that cataplexy in children can be especially hard to detect because it often looks different than the full paralysis more commonly associated with cataplexy. “It wasn’t until I connected with other people with narcolepsy and started treatment that I realized I had mild cataplexy-knee buckling, losing my grip and dropping things, and a slight loss of muscle tone in my neck,” she says. “I think a very important point is that milder forms of cataplexy, especially in children, are often overlooked by physicians,” she says.įor instance, Steiner says, she was initially diagnosed with narcolepsy without cataplexy because the screening questions focused on severe manifestations of cataplexy. It’s important for physicians to recognize this variability, says Steiner, who was diagnosed with narcolepsy at age 35. In its mildest form, cases of cataplexy may not be noticed for decades, says Julea Steiner, MPH, CHES, assistant professor at the University of North Carolina Gillings School of Global Public Health. In the most severe cases, a person’s body may collapse suddenly or look like a ragdoll, slowly folding to the ground. It can happen several times throughout the day or might vanish for years at a time, says Krahn. The paralysis can last just seconds or minutes. Patients might experience paralysis in some or all of their voluntary muscles. It can occur in babies as soon as they are able to crawl, which then allows the identification of cataplexy, but it is rare that it is picked up that early,” says Black. “We can see symptom onset occurring very early. 1 Half of all patients with narcolepsy have symptoms before the age of 15. Symptoms usually develop between ages 10 and 20. The typical age of onset is in childhood or adolescence. If someone is going to develop cataplexy, the majority will develop it within a few months to weeks after the development of narcolepsy. There can be waxing and waning and it has been mischaracterized by some as cataplexy improving over time.” “A lot of patients can experience that, but some individuals can have multiple attacks per hour others can have one every few months or one a year, or less than that. “When you read in the textbooks about cataplexy, you read about voluntary muscle weakness that is equal on both sides of the body and it is often described as producing a complete collapse,” says Black. In others, only the upper body may be affected, the head and arms may collapse, while the person remains standing. The eyes may partially close, their jaws can become slack, and speech may become slurred. This could impact the muscles in the face or the neck. There will be some patients who will never have a full attack, just experiencing partial paralysis of isolated parts of the body. Many people report that their cataplexy becomes less severe over time, but these cases could be attributed to changes in behavior or medication compliance, and it’s still debated whether there is a natural evolution of cataplexy over a person’s lifetime.Īccording to Black, it’s challenging to know what to expect as people age. The variability among narcoleptic patients with cataplexy is wide, but the emotional triggers usually remain the same as people age, says Black. After someone retires, they might realize that the stress of work was a significant factor in worsening their cataplexy, says Jed Black, MD, an adjunct professor at Stanford University’s Center for Sleep Sciences and Medicine. A death of a spouse late in life can trigger severe cataplexy after years without any episodes. In some instances, environmental factors can profoundly impact a person’s symptoms. So while it may appear like their symptoms are improving with age, they might just be learning to cope better with time. Krahn, MD, a psychiatrist at the Mayo Clinic. Since cataplexy is triggered by strong emotions, some patients can be taught how to block out their feelings through meditation techniques or by avoiding triggers, says Lois E. With more experience, people with narcolepsy can learn to better control their cataplexy, but that doesn’t necessarily mean their sleep disorder has become less severe.Īs people age, they may be more likely to fall and injure themselves, but patients who suffer from cataplexy-a symptom of narcolepsy that causes loss of muscle tone-have a lifetime to learn about how to stay safe when their bodies fail them.
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