maniaclooki.blogg.se - Cataplexy attacks

detection of pathological drowsiness (hypersomnia) by questioning according to the Euphord Sleepiness Scale.

setting the level of biological need for sleep by conducting MSLT testing - a multiple latency test for sleep (no later than two hours after waking from a night's sleep).

studying the features of night sleep with polysomnography.

finding out all the patient's illnesses and the medications taken by him.

examination of the patient, fixing his complaints and collecting anamnesis.

The diagnosis of cataplexy is performed by a neurologist and consists of: In addition, in the history of patients with cataplexy syndrome there is a short-term loss of muscle tone right after a night's sleep - the so-called cataplexy of awakening, and there are disturbances in the normal structure of sleep in the form of anxiety, hallucinations when falling asleep and negative emotional coloring of dreams (often all nightmares are dreamed). Symptoms most often occur in adolescence or 20-30 years, in children narcolepsy and cataplexy is diagnosed in less than 5% of cases, most of the patients are male.

But hearing and understanding are not violated.Īs specialists note, atony can be partial, affecting only the muscles of the face and neck. Vision also deteriorates: double vision (diplopia) and problems with focusing. In most cases, when the cataplectic seizure is caught in a standing position, a person can not restrain himself and falls.Īt the same time, the person does not lose consciousness, breathing does not stop, but the heartbeat may slow down face turns red, throws into sweat speech inarticulate (due to relaxation of mimic and chewing muscles of the face).

Typical symptoms of cataplexy are expressed in the form of atonic muscle attacks lasting from a few seconds to several minutes, during which a person - due to the disappearance of normal physiological muscle tension - the mandible is hanging down, the head is lowered or tilted, the legs bend at the knee joints "), Hands hang along the body. Secondary cataplexy may occur as a result of damage to the hypothalamic region of the brain by tumor formations or metastases of breast, thyroid or lung cancer, due to congenital anomalies of the cerebral vascular system, multiple sclerosis, craniocerebral trauma, or infections. On this basis, this condition could be classified as diencephalic syndromes of a disgormonal nature. In general, the neurophysiological mechanism of the development of cataplexy remains unclear, although a certain correlation between the lack of this mediator of the nervous system and the decrease in the level of such important neurotransmitter hormones as histamine, dopamine and adrenaline is found. What exactly leads to the loss of brain cells producing this neuropeptide has not yet been established, but scientists agree that this is a genetically transmitted (modified form of the DQB1 0602 gene) pituitary pathology of an autoimmune nature.Īccording to the second version, cataplexy causes not a hypocretin deficiency, but a defect of receptors perceiving it. The currently accepted version of the etiology of narcolepsy and cataplexy is the lack or destruction of hypothalamus cells that produce hypocretin (orexin), a neurotransmitter that regulates the processes of excitation and wakefulness. Scientific studies of the last 15 years have shown that the periodic inhibition of the transmission of nerve impulses and the instantaneous decrease in muscle tone in this pathology is due to problems with the hypothalamus.

This is the primary cataplexy (or the Levenfeld-Genneberg syndrome). And this syndrome is not related to the pathology of the musculoskeletal system, but is directly related to the brain and the central nervous system. Before considering the most important causes of cataplexy, it should be borne in mind that, according to the European Federation of Neurological Societies (EFNS), narcolepsy and cataplexy, more precisely, cataplexy syndrome, is observed in an average of 70-80% of patients with diagnosed narcolepsy - increased drowsiness in daytime time.