TY - JOUR
T1 - The distinguishing motor features of cataplexy
T2 - A study from video-recorded attacks
AU - Pizza, Fabio
AU - Antelmi, Elena
AU - Vandi, Stefano
AU - Meletti, Stefano
AU - Erro, Roberto
AU - Baumann, Christian R.
AU - Bhatia, Kailash P.
AU - Dauvilliers, Yves
AU - Edwards, Mark J.
AU - Iranzo, Alex
AU - Overeem, Sebastiaan
AU - Tinazzi, Michele
AU - Liguori, Rocco
AU - Plazzi, Giuseppe
N1 - Ricercatori distaccati presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Pizza Fabio, Antelmi Elena, Vandi Stefano, Liguori Rocco, Plazzi Giuseppe).
La Dr.ssa E. Antelmi ha pubblicato anche lavori con affiliazione straniera che descrivono i risultati del progetto di ricerca svolto al “Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London” nel corso dei 3 anni della sua permanenza precedente presso l’Istituto (2014-2016).
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Study Objectives: To describe the motor pattern of cataplexy and to determine its phenomenological differences from pseudocataplexy in the differential diagnosis of episodic falls. Methods: We selected 30 video-recorded cataplexy and 21 pseudocataplexy attacks in 17 and 10 patients evaluated for suspected narcolepsy and with final diagnosis of narcolepsy type 1 and conversion disorder, respectively, together with self-reported attacks features, and asked expert neurologists to blindly evaluate the motor features of the attacks. Video documented and self-reported attack features of cataplexy and pseudocataplexy were contrasted. Results: Video-recorded cataplexy can be positively differentiated from pseudocataplexy by the occurrence of facial hypotonia (ptosis, mouth opening, tongue protrusion) intermingled by jerks and grimaces abruptly interrupting laughter behavior (i.e. smile, facial expression) and postural control (head drops, trunk fall) under clear emotional trigger. Facial involvement is present in both partial and generalized cataplexy. Conversely, generalized pseudocataplexy is associated with persistence of deep tendon reflexes during the attack. Self-reported features confirmed the important role of positive emotions (laughter, telling a joke) in triggering the attacks, as well as the more frequent occurrence of partial body involvement in cataplexy compared with pseudocataplexy. Conclusions: Cataplexy is characterized by abrupt facial involvement during laughter behavior. Video recording of suspected cataplexy attacks allows the identification of positive clinical signs useful for diagnosis and, possibly in the future, for severity assessment.
AB - Study Objectives: To describe the motor pattern of cataplexy and to determine its phenomenological differences from pseudocataplexy in the differential diagnosis of episodic falls. Methods: We selected 30 video-recorded cataplexy and 21 pseudocataplexy attacks in 17 and 10 patients evaluated for suspected narcolepsy and with final diagnosis of narcolepsy type 1 and conversion disorder, respectively, together with self-reported attacks features, and asked expert neurologists to blindly evaluate the motor features of the attacks. Video documented and self-reported attack features of cataplexy and pseudocataplexy were contrasted. Results: Video-recorded cataplexy can be positively differentiated from pseudocataplexy by the occurrence of facial hypotonia (ptosis, mouth opening, tongue protrusion) intermingled by jerks and grimaces abruptly interrupting laughter behavior (i.e. smile, facial expression) and postural control (head drops, trunk fall) under clear emotional trigger. Facial involvement is present in both partial and generalized cataplexy. Conversely, generalized pseudocataplexy is associated with persistence of deep tendon reflexes during the attack. Self-reported features confirmed the important role of positive emotions (laughter, telling a joke) in triggering the attacks, as well as the more frequent occurrence of partial body involvement in cataplexy compared with pseudocataplexy. Conclusions: Cataplexy is characterized by abrupt facial involvement during laughter behavior. Video recording of suspected cataplexy attacks allows the identification of positive clinical signs useful for diagnosis and, possibly in the future, for severity assessment.
KW - cataplectic facies
KW - cataplexy
KW - functional neurological symptom disorder
KW - narcolepsy
KW - pseudocataplexy
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U2 - 10.1093/sleep/zsy026
DO - 10.1093/sleep/zsy026
M3 - Article
C2 - 29425380
AN - SCOPUS:85047176044
VL - 41
JO - Sleep
JF - Sleep
SN - 0161-8105
IS - 5
M1 - 026
ER -