Gender and cultural differences in presentation However, narcolepsy is usually more difficult to identify in children. Frequently, narcolepsy is misdiagnosed in children as a learning disability or attention deficit disorder. Children frequently exert confusion and aggressive behaviors when woken up. Children with narcolepsy also suffer from excessive daytime drowsiness and cataplexy which is most often described as fainting in young children. Narcolepsy can occur in children as young as five, but is more prominent during adolescence, though it is also possible for it to develop during young adulthood. Approximately forty percent of individuals with narcolepsy experience comorbidity with depression, anxiety, or substance-related abuse, and some may also experience all symptomatologies associated with narcolepsy. The episodes can last anywhere from several seconds to several minutes. Occurrences of narcolepsy may be prompted by sudden emotional reactions such as anger, surprise, fear, or even laughter. Symptoms also include hypnagogic hallucinations, automatic behavior, insomnia and fragmented sleep associated with excessive day time sleepiness (EDS). During a time of excessive sleepiness, an individual with narcolepsy may temporarily experience muscle instability leading to paralysis or cataplexy of the head and body while the person remains awake and entirely conscious. People with narcolepsy experience an inadequate order and length of NREM and REM sleep stages which are disrupted REM sleep episodes during sleep onset instead of after NREM sleep. Narcolepsy is a neurological disorder in which the brain conveys sleep evoking signals at unexpected and inappropriate times. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or another general medical condition. Recurrent intrusions of elements of rapid eye movement (REM) sleep into the transition between sleep and wakefulness, as manifested by either hypnopompic or hypnagogic hallucinations or sleep paralysis at the beginning of end of sleep episodes.Ĭ. The presence of one or both of the following:Ĭataplexy (brief episodes of sudden bilateral loss of muscle tone, which is most often associated with intense emotion.) Irresistible attacks of refreshing sleep that occurs daily over at least 3 months.ī. Treatment paradigms for cataplexy in narcolepsy: Past, present, and future.147 Narcolepsy (347.00) DSM-IV-TR criteriaĪ. Cataplexy and its mimics: Clinical recognition and management. Thinking outside the box: Cataplexy without narcolepsy. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. If antidepressants don’t work, sodium oxybate (Xyrem) is often the next choice. Off-label means the medications are intended to treat symptoms of depression, but they’ve also been found to relieve symptoms of cataplexy.Īntidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are common options. When treatment is required, off-label antidepressant medication is the most common. Your doctor might have to try a few different medications to find one that works right for you. There’s no cure for cataplexy, but medications are often an effective way of reducing episodes. That way, someone can keep an eye out for episodes to ensure the person with cataplexy is safe if one occurs.īut if episodes are frequent, treatment might be needed. Instead, their doctor might recommend that they let trusted family, friends, and coworkers know about the episodes. For instance, people who have mild cataplexy episodes once or twice a year might not need a formal treatment plan. Treatment for cataplexy depends on how often your episodes happen and how severe they are. How is cataplexy without narcolepsy treated?
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