![]() The loss of muscle tone during cataplexy resembles paralysis of muscle activity that naturally occurs during REM sleep. But even during the most severe episodes, people remain fully conscious, a characteristic that distinguishes cataplexy from fainting or seizure disorders. The most severe attacks result in a total body collapse during which individuals are unable to move, speak, or keep their eyes open. Attacks may be mild and involve only a momentary sense of minor weakness in a limited number of muscles, such as a slight drooping of the eyelids. In about 10 percent of cases of narcolepsy, cataplexy is the first symptom to appear and can be misdiagnosed as a seizure disorder. Some people may only have one or two attacks in a lifetime, while others may experience many attacks a day. The symptoms of cataplexy may appear weeks or even years after the onset of EDS. It is often triggered by sudden, strong emotions such as laughter, fear, anger, stress, or excitement.
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