Can a small child have cataplexy without narcolepsy?
It’s possible. Whether he maintains consciousness during these attacks is important. I don’t have my sleep medicine text here now, but these are excerpts from a highly regarded online medical textbook: “EPIDEMIOLOGY — Narcolepsy with cataplexy is estimated to have a prevalence of 25 to 50 per 100,000 people and an incidence of 0.74 per 100,000 person-years. It is equally common in men and women. The disease typically begins in the teens and early twenties, but can occur as early as five years of age or after 40 years of age. The symptoms may worsen during the first few years and then persist for life.” “CLINICAL FEATURES — Narcolepsy can be viewed as a disorder of sleep-wake state control in which elements of sleep intrude into wakefulness, and elements of wakefulness intrude into sleep. The net effect is daytime sleepiness with varying amounts of hypnagogic hallucinations, sleep paralysis, and cataplexy. Only about one-third of patients will have all four of these classical symptoms;
Narcolepsy is suspected to be autoimmune in many cases, involving the death of cells that produce orexin / hypocretin (same peptide hormone, two names for it) in the hypothalamus. Brain damage might cause a similar cell death. The peptide isn’t needed to maintain wakefulness but is important in stabilizing sleep/wake cycles. Without a functional orexin system, the brain can flip between sleep and wakefulness at random, but often through common triggers like food availability or laughing. The short answer is that only a clinical workup can tell you whether your son is narcoleptic. You might be asked for permission to sample blood or CSF to test for the presence of orexin. A check at a sleep clinic will also likely be in order, to see whether sleep cycles are disrupted (narcolepsy doesn’t just cause sleep to intrude into wakefulness; wakefulness also interrupts sleep cycles). The best thing you can do is talk to a doc. There are other problems that go along with narcolepsy – for example
