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


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.

“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.”

At the 71st American Academy of Neurology Annual Meeting in Philadelphia, Pennsylvania, Michael Thorpy, MBChB, spoke with NeurologyLive to discuss one of the major symptoms of narcolepsy: cataplexy.

The director of the Sleep­-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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