Clinical Presentation & History
A 29-year-old woman with known narcolepsy type 1 presents after collapsing repeatedly on a sidewalk during emotional distress; she has sustained minor head trauma and reports partial awareness during falls.
Emergency Resuscitation
Sleep Medicine
IC-EM-00954
Intermediate Level
Cataplectic Crisis: Relentless Collapses in Narcolepsy
Cataplectic Crisis: Relentless Collapses in Narcolepsy - Sleep Medicine clinical simulation case. A 29-year-old woman with known narcolepsy type 1...
Age: 29 • Gender: Female • Setting: Emergency Triage
Acute Resuscitation Milestones & Priorities
Clinical phases and key interventions encountered in this emergency module:
- Initial Triage & Safety Stabilization
- Diagnostic Workup & Precipitant Hunt
- Acute Cataplexy Rescue & Injury Prevention
- Disposition, Counseling & Relapse Prevention
High-Yield Clinical Pearls
Cataplexy is characterized by abrupt bilateral loss of muscle tone with preserved consciousness, classically triggered by strong emotions such as laughter, anger, or surprise.
Sodium oxybate withdrawal and sleep deprivation are the most common precipitants of status cataplecticus; prompt reinstitution reduces relapse risk.
First-line maintenance combines sodium oxybate (REM stabilizer) with a wakefulness-promoting agent such as modafinil; noradrenergic agents such as reboxetine or venlafaxine offer adjunctive cataplexy suppression.
Driving clearance in cataplexy requires sustained remission on optimized therapy, not a single symptom-free interval, due to catastrophic crash risk.