3/27/2023 0 Comments Cataplexy triggers![]() ![]() I call it a reverse of a tic, because they get the muscle weakness and then it comes back, so there’s almost a jerky quality. Other presentations can be shoulder weakness, arm weakness, weakness of the hand, buckling of the knees, and ankles getting weak. Weakness in the jaw is especially common in pediatric cases of narcolepsy, where the jaw thrusts forward and the tongue may protrude a little. But you can have drooping eyelids, blurred vision, or weakness in the tongue muscles. Some have a strong emotion and have their head drop that’s pretty common. When I talk to my patients, I’ll ask them about cataplexy starting from the head and working my way down. The presentation is different for everybody. Any strong emotion that causes the muscle weakness is cataplexy. For other people, listening to music that’s very moving to them can cause some cataplexy. I’ve read that if somebody meets up with an old friend and they’re surprised and emotional at the same time, that can cause it. But it can also occur with frustration, sexual excitation, disgust, being surprised. It can occur with laughter and anger, which are the most common. I want you to ask the people around you.” Sometimes you’ve got to get third-party history to get the symptom of cataplexy.Ĭataplexy is any muscle weakness with a strong emotion. Cataplexy is a symptom where if they say no, then I say, “I want you to think about this. They may not even realize that when they laugh or have a strong emotion, they’re doing something unusual with their face or they’re having a muscle collapse or something. The other thing that’s important to note is patients sometimes aren’t the best historians about cataplexy. In my mind, I thought, “When I see that, I’ll know that’s cataplexy.” I’ve worked in sleep medicine for many years now, so I realize that cataplexy can present in a variety of ways and is often very subtle. The patient had narcolepsy and fell on the floor. ![]() I’d love to hear your thoughts on how cataplexy generally presents in your practice, how you recognize it, and how you differentiate from other diagnoses often given to these patients who may have partial cataplexy.ĭebra Stultz, MD: I remember a very similar case from when I was in medical school. Haramandeep Singh, MD: When we talk about classic cataplexy, we know that cataplexy generally doesn’t present in this manner. ![]()
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