Cataplexy

An abrupt temporary loss of voluntary muscular function and tone, sometimes evoked by an emotional stimulus such as laughter, pleasure, anger or excitement. The attacks can last just a few seconds or many minutes. They may end in the resumption of normal behaviour or be followed by sleep for half an hour.

• Cataplexy is often associated with narcolepsy and can affect 60% to 90% of patients with narcolepsy
• Isolated cataplexy is rare
• Are triggered by emotions such as anger, surprise, laughter and exhilaration.

• Attacks vary considerably in severity from a barely susceptible slackening of the facial muscles, dropping of the jaw or the entire head, weakness at the knees or collapse on to the floor
• Speech is slurred and eyesight impaired with blurring or double vision. Hearing and awareness remain unaffected.

• Epilepsy
• Syncope¹

An EEG and MRI of the brain may be required in order to rule out any other possible cause (there have been a few reports of cataplexy associated with intracranial space-occupying lesions).

Narcolepsy

• Family members need to learn when the patient may need assistance
• Full-blown cataplectic attacks can be frightening. Attention must be given to the emotional impact on both the patient and the rest of the family
• There is no known cure for cataplexy and treatment focuses on controlling symptoms. Therefore drug treatment should be avoided if cataplexy is not causing a significant problem for the patient
• Tricyclic antidepressants (clomipramine² and impramine) and SSRIs (fluoxetine³) have been shown to be effective
• Sodium oxybate is also an effective treatment⁴.

Patients with cataplexy will often avoid social situations which may lead to attacks and they can therefore become socially isolated.

Usually improves with time.