Cataplexy 101

Last updated: May 2022

If you have narcolepsy, there’s a chance you experience cataplexy. Cataplexy is the sudden, temporary loss of muscle tone leading to weakness and loss of voluntary muscle control. It is often triggered by strong emotions like laughter, fear, anger, or sadness. Cataplexy is a hallmark symptom of type 1 narcolepsy.1

I treat my cataplexy with high doses of antidepressants, which reduce my cataplexy and hypnagogic hallucinations.

Cataplexy can show itself in many different ways. Here are a few of them:

1. Complete paralysis

Have you ever tried to defend yourself in an argument, only for your muscles to give out completely, ending with you landing in a heap waiting for your full-body paralysis to pass?

Severe cataplexy attacks look like this. And cataplexy like this can be very dangerous. People can get seriously injured by falling to the ground. Those with severe cataplexy can hit their heads, injure their faces and bodies, and even bite their tongues.

I also find myself struggling to breathe during episodes of complete paralysis due to not being able to move my chin away from my chest. Falling into an uncontrolled heap can kink my neck forward and make it difficult to breathe effectively. This can make the experience even scarier.

2. Knee buckling

Have you ever laughed at a joke so hard that your knees start to give out?

Cataplexy attacks that affect the legs can cause you to fall to the ground, but perhaps softer than complete cataplexy paralysis would. This is because you can at least try to catch yourself with your hands.

When I experience knee-buckling cataplexy, I lock my knees to stay standing and try to shut out the emotion that I am experiencing. If I am unsuccessful in stopping the cataplexy attack this way, I will bring my weight forward so I can fall just a short way to the ground and kneel safely until the attack is over.

3. Limp limbs

Have you ever dropped something because of your arms or hands giving out?

Cataplexy attacks that affect the upper limbs can cause accidents, too. For example, if you have a cataplexy attack that affects your arms while driving, you can cause a serious accident. Other examples might include dropping dishes after having a strong emotion, or having shaky hands while writing and feeling a strong emotion.

Sometimes when I am typing something passionately, my fingers begin to shake and have difficulties finding the right keys. This can mess up my writing flow and cause me to lose my train of thought.

4. Head bobbing

The first time I experienced cataplexy, it presented itself as head bobbing. When laughing at a joke, my head would fall forward uncontrollably. My neck and shoulders would become temporarily paralyzed.

This can impair my breathing and cause me to panic a little bit. Taking the time to try to relax and let the paralysis attack pass while struggling to breathe can be difficult.

5. Drooping face

Lastly, have you ever seen a stroke patient's face? The muscles droop on one side and continue working on the other side, resulting in a sideways facial expression.2

Cataplexy of the face results in the entire face being droopy as opposed to just one side. This can cause the mouth to gape open, the forehead to droop low over the brows and eyes, and even the eyes to close.

Facial cataplexy is embarrassing to me. I don’t like how my face looks when I can’t control my expression or even open my eyes.

Do you experience cataplexy attacks similar to the types described here? Are there other ways? Share with us in the comments below!

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