Cataplexy represents an episode in which body loses its muscle tone, mainly because of emotions. The original name comes from greek, plexis traduced as paralysis and kata as down. Statistically speaking, this illness is a rare one and it is usually associated with narcolepsy. To be more specific, only 4-5 people from 10 000 suffer from cataplexy. Patients with narcolepsy experience sleep problems, sleep attacks and paralysis, excessive sleepiness during the day , hypnagogic hallucinations, etc.
A superficial consult can lead to confusions between cataplexy and epilepsy, because of the seizures that both diseases present. The main difference is in the stimuli that produce both types of seizures. Another type of cataplexy is the one manifested as a side effect of a syndrome named SSRI (selective serotonin re-uptake inhibitor) withdrawal syndrome, colloquially called the zaps.
The loss of muscle tone characteristic for cataplexy can vary from mild slackening to completely loss of muscular control. It begins with the facial groups of muscles but can affect also the head, the knees and finally the whole body. In consequence, there are affected only the functions that involve important muscle control as speaking, seeing – the patient can’t focus, or has a double vision – walking, sitting up. Awareness, on the other hand, and hearing, are not affected during the attacks.
The factors that trigger the seizures are mainly strong emotions like anger, awe, surprise, exhilaration, embarrassment, orgasm or even laughter. The most common safety measure would be to avoid experiencing such emotions but this can lead to mental and emotional restrictions and finally to a life reduction, so that once the symptoms are experimented, the treatment should be begun quickly.
The stages of the disease are vary from partial to complete, involving groups of muscles, gradually, until the entire muscular system is affected (rare forms). The illness starts with a mild weakness of the upper limbs and a sagging of the jay. Than expands to drooping hands, difficulties in speaking, fallen shoulders, ending with a generalized weakness and then with the buckling of the knees.
Impact on life
If the seizures occur very often, they can have a major impact on a normal life. The patients gets to drop object, fall on the street or he is not able to drive anymore. This generates accidents and embarrassment if the others see the patient during the attacks. The best examples in this case are the cataplexic parents afraid of carrying their own baby because they can drop him.
A major risk of those who suffer from cataplexy is to be pronounced dead after a superficial consult. A well-known example is Allison Burchell, who had this unpleasant experience three times during the disease evolution. This happens because cataplexy makes the vital signs very hard to detect when the persons in charge with the diagnosis doesn’t have a continuous auditory pulse oximeter.
Although it is strongly related with narcolepsy, doctors prescribe different medication for the two diseases. In the past, tricyclic antidepressants were a good cure for cataplexy. Imipramine, protriptyline and clomipramine are three well-known substances in this case. The biggest disadvantage was that they had visible side-effects and in conclusion the doctors changed them with newer antidepressants like venlafaxine. A chemical with benefic effects on both diseases (lowering also the sleepiness during the day) is (sodium)gamma-Hydroxybutyrate GHB. Moreover, hypnagogic hallucinations or sleep paralysis are managed by monoamine oxidase inhibitors, substances which manage the cataplexic attacks.