Michael J. Thorpy, MBChB

“Cataplexy is difficult to diagnosis, and physicians, one of the big mistakes they make is that they tend to ask the patient once about cataplexy and if they get a negative answer, they move on and they never ask the patient again, and that’s a really big mistake.”

 American Academy of Neurology Annual Meeting in Philadelphia, Pennsylvania, Michael Thorpy, MBChB, spoke with 

to discuss one of the major symptoms of narcolepsy: cataplexy.

The director of the Sleep&shy;-Wake Disorders Center at Montefiore Medical Center explained that cataplexy is the pathognomonic symptom of narcolepsy, however, it often goes undiagnosed. The course of cataplexy usually changes over time, and while the presentation may start out subtle it could become more pronounced as time goes on.

One symptom of cataplexy that’s rarely recognized is jerking of the muscles of the face, particularly around the eyes, and if a clinician notices that while evaluating a patient, they might also notice flattening of the face and drooping of the head which would give a clue to cataplexy. According to Thorpy, one of the biggest mistakes that clinicians make is asking patients only once about cataplexy. Clinicians should instead reinvestigate patients numerous times.

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 The director of the Sleep-Wake Disorders Center at Montefiore Medical Center spoke about one of the major symptoms of narcolepsy and how to identify it during diagnosis.  

Michael J. Thorpy, MBChB: The Subtle Manifestations of Cataplexy

"Narcolepsy is an interesting disorder that's getting a lot of attention these days, so there's far more interest in it because people are recognizing it more even though there's still a very long delay from the onset of symptoms to the time of diagnosis."

At the SLEEP 2019 annual meeting, held in San Antonio, Texas, June 8&shy;—12, Michael Thorpy, MBChB, spoke about the challenges in diagnosing narcolepsy and the implications for a multimodal therapy approach.

To dive deeper into his presentation and the clinical features and signs that physicians should be aware of, Thorpy spoke with 

Thorpy explained that while physicians are aware that narcolepsy causes 2 major symptoms, excessive daytime sleepiness and oftentimes cataplexy, there are many patients that only present with excessive daytime sleepiness and not cataplexy, making this patient population more difficult to diagnose. When making a diagnosis of type 2 narcolepsy, one is very much dependent on the clinical features and symptoms in patients because patients are more than likely to have falsely negative MSLTs.

The director of the Sleep-Wake Disorders Center at Montefiore Medical Center spoke about the challenges in diagnosing narcolepsy, which often adds to the delay of diagnosis.
 

Michael J. Thorpy, MBChB

Articles

Michael J. Thorpy, MBChB: The Subtle Manifestations of Cataplexy

Michael J. Thorpy, MBChB: Challenges of Diagnosing Narcolepsy