Importantly, management also needs to involve sleep hygiene advice, safety measures whenever applicable and guidance with regard to the social sequelae of cataplexy.Ĭataplexy Drop attacks Narcolepsy Pseudocataplexy Sodium oxybate Syncope. Subjective descriptions of cataplexy can assist in the identification of narcolepsy, as this feature is almost unique to the disorder. Symptomatic treatment is possible with antidepressants and sodium oxybate. Cataplexy, a physical feature of narcolepsy, is characterized by transient episodes of voluntary muscle weakness precipitated by intense emotion.
PARTIAL CATAPLEXY SERIES
Over time, these severe symptoms evolve to the milder adult phenotype, and this pattern is crucial to recognize when assessing the outcome of uncontrolled case series with potential treatments such as immunomodulation. Cataplexy shows remarkable differences in childhood compared to adults, with profound facial hypotonia and complex active motor phenomena.
Currently, the diagnosis of cataplexy is made almost solely on clinical grounds, based on history taking and (home) videos. Childhood narcolepsy, with its profound facial hypotonia, can be confused with neuromuscular disorders, and the active motor phenomenona resemble those found in childhood movement disorders such as Sydenham's chorea. They can be differentiated from cataplexy using thorough history taking, supplemented with (home)video recordings whenever possible. Cataplexy mimics include syncope, epilepsy, hyperekplexia, drop attacks and pseudocataplexy. However, pitolisant effectiveness on orgasmolepsy in NT1 has no precedent in the literature. Real-world data collection on pitolisant efficacy and safety is still ongoing. Next to narcolepsy, cataplexy can sometimes be caused by other diseases, such as Niemann-Pick type C, Prader Willi Syndrome, or lesions in the hypothalamic or pontomedullary region. Pitolisant is a novel treatment for narcolepsy, effective on excessive daytime sleepiness and cataplexy by modulating the histaminergic system.
Moreover, childhood cataplexy differs from the presentation in adults, with a prominent facial involvement, already evident without clear emotional triggers ('cataplectic facies') and 'active' motor phenomena especially of the tongue and perioral muscles. The expression of cataplexy varies widely, from partial episodes affecting only the neck muscles to generalized attacks leading to falls. Cataplexy, a common symptom of narcolepsy triggered by strong emotional stimuli, is characterized by a partial or total muscle weakness affecting the face. Although cataplexy is rare, its recognition is important as in most cases, it leads to a diagnosis of narcolepsy, a disorder that still takes a median of 9 years to be diagnosed. This review describes the diagnosis and management of cataplexy: attacks of bilateral loss of muscle tone, triggered by emotions and with preserved consciousness.
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