The exact pathophysiology of how this occurs is not clear for each of these conditions, although there are several suggestions and it is generally thought to be associated with cellular damage. These conditions are likely to contribute to the cause due to their impact on the neurons that are involved in the production of hypocretin. Symptoms of Narcolepsy can include excessive daytime sleepiness (EDS), sleep disruption, cataplexy, sleep paralysis and hypnagogic/hypnopompic hallucinations. Other associated health conditions include: The lesions typically present in the lateral and posterior hypothalamus but can also affect other areas of the brain, such as the stem, and can usually be detected with imaging techniques, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans. This may be an astrocytoma, glioblastoma, glioma, subependymoma or other types of tumor. The most common condition is a tumor or lesion in the brain that obstructs the cells that produce hypocretin and affects the level of the neurotransmitter in the central nervous system. ![]() Secondary cataplexy refers to the characteristic episodes of sudden muscle weakness that are caused by an underlying health condition. For example, if the individual is walking when the attack begins that cannot control the simple movement during the attack, although they remain conscious. When this occurs during an active movement, a cataplectic attack can occur, when the loss of muscle control affects the fulfillment of the activity. The lack of muscle tone is thought to be caused by the widespread inhibition of motor neurons in the nervous system, particularly the spinal cord. It has been suggested that the cataplexy episodes are associated with muscular paralysis in the REM sleep cycle. The immune system is thought to be involved in this process and, in many cases, it is an autoimmune response triggered by an infection that causes the cell destruction. The reason for the destruction of the neurons that affect the production of hypocretin can vary greatly. ![]() If severe and generalized, it may cause a fall. ![]() 1,2 Cataplexy also may be quite difficult to recognize and diagnose. Cataplexy is a brief and sudden loss of muscle tone and represents REM sleep intrusion during wakefulness. Cataplexy is the most specific symptom of narcolepsy. In patients that suffer from cataplexy, these neurons are destroyed or disabled, which disrupts the production of hypocretin and can lead to episodes of cataplexy. How narcolepsy patients experience cataplexy. There are several neurons in the hypothalamus that are usually involved in the process of production of hypocretin in the brain cells. Hypocretin in a neurotransmitter, also known as orexin, that plays an important role in the central nervous system to regulate the sleep-wake cycle and cause individuals to experience wakefulness.
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