In relation to EDS, people with narcolepsy frequently have a hard time concentrating or focusing, making everyday activities like driving and cooking dangerous. People with narcolepsy may wake up feeling rested and alert, but they will often have trouble staying awake for long periods of time. The individual feels persistently sleepy, no matter how much sleep he or she gets at night. The most obvious narcolepsy symptom is excessive daytime sleepiness (EDS) which refers to an inability to stay alert during normal daytime hours. Possible triggering events include hormonal changes, major stress, a brain injury, or an infection. After that, the body’s immune system becomes confused and mistakenly attacks the brain cells that produce orexin which then leads to symptoms of narcolepsy. Researchers currently believe that people are born with a genetic predisposition to develop narcolepsy eventually, often during childhood or teenage years, a triggering event may cause the onset of narcolepsy. Most cases of narcolepsy are thought to be due to a lack of a brain chemical called orexin (or hypocretin), which promotes wakefulness and helps to regulate sleep. People with narcolepsy may struggle to maintain academic, professional, and social activities. While narcolepsy doesn’t cause serious or long-term physical health issues, it can be hard to cope with in daily life and can often lead to emotional distress. Symptoms usually start to appear in childhood or young adulthood however, the onset of narcolepsy can occur at any life stage. Narcolepsy affects men and women equally. As a result, people with narcolepsy often feel excessively fatigued and frequently fall asleep during daytime hours, even when they’re engaged in conversation, work, or other activities. People with narcolepsy may wake up in the morning feeling well-rested, but they’re unable to sustain that alertness throughout the day. Narcolepsy is a neurological disorder that affects the brain’s ability to regulate the sleep-wake cycle. Learn about the risk factors and symptoms of narcolepsy, along with how to get a diagnosis and what treatment options are available. These symptoms could be a sign that you have narcolepsy, a chronic sleep disorder that causes a person to fall asleep suddenly and at inappropriate times. 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.When is extreme tiredness more than just exhaustion? Know the signs and symptoms of narcolepsy, plus diagnosis and treatment options.Įxcessive fatigue and daytime sleepiness aren’t always just the result of a few nights of poor sleep. Symptomatic treatment is possible with antidepressants and sodium oxybate. 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. 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. 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. 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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