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Sleep Apnea (Expert Forum)
Cataplexy without Narcolepsy??
Answered by
Steven Y Park, MD - sleep-breathing disorders
Private Practice
New York - NY
Questions in the Sleep Breathing Disorders Forum are being answered by Dr. Steven Y. Park.
Cataplexy without Narcolepsy??
by Katylynn1692, Jan 04, 2009 12:55PM
I'm a 17 year old female.
For the past 2 1/2 years I have been having full body collapses. These "attacks" are triggered by heat, stress, fear, anger, excitement, and especially laughter.
During an attack, I am completely unable to move, but I can still hear and feels things. I have had attacks during EEG's and they show that I am still awake. Also, my blood pressure, heart rate, and temperature go up.
I was previously diagnosed with Conversion Disorder, a psychological condition where a patient presents with physical symptoms, but there is no physical reason for the symptom; it's triggered by extreme emotional stress.
After treatment for 6 months with an antidepressant (Celexa) , which did cut down the frequency and length of the attacks, I started seeing a psychologist. He told me that he no longer felt I had CD. After trying another antidepressant (Prozac) I tried Lamictal to rule out seizures, another possible despite testing. After the Lamictal, I was put on Concerta. The attacks have cut down to almost nothing, going from 1 a day to 1 a month. In the past 3 months, I have only had 3!
So my doc has said that I have Cataplexy, but the MSLT and Sleep study I had a few years ago was negative. I have also never shown any symptoms of Narcolepsy, no EDS, no sleep paralysis or hallucinations. I was wondering what the chances are of this being the case.
I have a few other symptoms that we aren't sure whether they are unrelated or not.
I lose nails. They fall off in one piece, like they just don't stay attached to my fingers and toes. The entire nail, including the matrix come off. No nail has grown in underneath first, and there is no injury to the nails.
I lose my hair. It's currently about 1/3 as thick as it was 2 years ago.
I have horrible pinpoint headaches, which happen very suddenly and last about 2-3 minutes.
Any help I can receive would be wonderful.
For the past 2 1/2 years I have been having full body collapses. These "attacks" are triggered by heat, stress, fear, anger, excitement, and especially laughter.
During an attack, I am completely unable to move, but I can still hear and feels things. I have had attacks during EEG's and they show that I am still awake. Also, my blood pressure, heart rate, and temperature go up.
I was previously diagnosed with Conversion Disorder, a psychological condition where a patient presents with physical symptoms, but there is no physical reason for the symptom; it's triggered by extreme emotional stress.
After treatment for 6 months with an antidepressant (Celexa) , which did cut down the frequency and length of the attacks, I started seeing a psychologist. He told me that he no longer felt I had CD. After trying another antidepressant (Prozac) I tried Lamictal to rule out seizures, another possible despite testing. After the Lamictal, I was put on Concerta. The attacks have cut down to almost nothing, going from 1 a day to 1 a month. In the past 3 months, I have only had 3!
So my doc has said that I have Cataplexy, but the MSLT and Sleep study I had a few years ago was negative. I have also never shown any symptoms of Narcolepsy, no EDS, no sleep paralysis or hallucinations. I was wondering what the chances are of this being the case.
I have a few other symptoms that we aren't sure whether they are unrelated or not.
I lose nails. They fall off in one piece, like they just don't stay attached to my fingers and toes. The entire nail, including the matrix come off. No nail has grown in underneath first, and there is no injury to the nails.
I lose my hair. It's currently about 1/3 as thick as it was 2 years ago.
I have horrible pinpoint headaches, which happen very suddenly and last about 2-3 minutes.
Any help I can receive would be wonderful.
Doctor's Answer
by Steven Y Park, MD, Jan 04, 2009 05:09PM
, Jan 04, 2009 05:09PM
It sounds like you've undergone all the right tests and tried all the right medications. I'm not aware of any condition related to cataplexy that also involves nails and hair falling off. Cataplexy alone doesn't automatically give you a narcolepsy diagnosis.
You may want to see another sleep doctor/neurologist for a second opinion. You also may want to post your question in the medical support communities to see if anyone else has similar symptoms. Good luck.
You may want to see another sleep doctor/neurologist for a second opinion. You also may want to post your question in the medical support communities to see if anyone else has similar symptoms. Good luck.
