Overview.
Cataplexy, a short-lived paralysis not accompanied by loss of consciousness, is caused by a sudden emotional reaction and is one of the common symptoms of sleep disorders. Clinical manifestations include head tilting forward or falling to the ground, decreased muscle tone, loss of pupillary response to light, diminished or absent tendon reflexes, and Babinski’s sign may be positive, but consciousness is clear and passes in a short period of time. It can be triggered by emotional excitement, sudden stress and laughter. It is often accompanied by episodic somnolence.
Etiology
The etiology is unknown and may be related to heredity or low-grade filtering viral infections, etc. Strong emotions such as ecstasy, sadness, anger, and fear can trigger SIDS. People with episodic sleeping sickness are particularly susceptible to the condition.
Symptoms
Mainly sudden onset of localized hypotonia and motor inhibition. Usually induced by sudden emotional excitement, laughter, fear or anger and other strong emotional stimuli, it manifests itself as a sudden loss of muscle tone throughout the body, with the patient falling down due to sudden muscle weakness, or tilting the head backward or bowing the head forward due to a sudden loss of muscle tone in the head, or a sudden loss of muscle tone in the face resulting in an expressionless face and slurred speech. However, the patient is conscious, does not affect memory, breathes normally, and recovers fully upon awakening. The duration of the seizure is usually less than 1 minute. If the patient is touched by another person during the seizure, the seizure can be aborted, or the patient may need to be shaken vigorously before recovering.
Examination
Cerebrospinal fluid is normal in laboratory tests. The electroencephalogram may have paroxysmal slow waves during the seizure and is normal during wakefulness. Cranial CT or cranial MRI is mostly normal, and if caused by thalamic lesions, there may be internal thalamic localization or localized atrophy. Physical examination shows low muscle tone in the limbs and absent tendon reflexes.
Diagnosis
1. Medical history
Most patients have a history of episodic sleep disorder.
2. Clinical manifestations
Seizures often occur during emotional excitement, characterized by sudden limb paralysis, inability to stand, lasting for several seconds or minutes to return to normal, not accompanied by loss of consciousness.
3. Auxiliary examination
Physical examination shows low muscle tone of the limbs and absent tendon reflexes.
Treatment
These patients should not be engaged in dangerous work such as overhead, underwater, driving and high-voltage electrical appliances to prevent accidents.
There is no cure for this disease, but symptomatic treatment is used to reduce the rate of seizures. Try not to take the above drugs after 4 p.m., so as not to affect the night sleep.
1. Promethazine 25mg, 3-4 times/day, orally.
2. Chlorpromazine 25mg, 1-3 times/day, orally.
Prognosis
SIDS is not a serious disease, but it is not curable. Patients most often have their first attack in adolescence and remain incurable throughout their lives.