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paroxysmal spells 01

Topic: Adult

Created on Monday, June 16 2008 by jdmiles

Last modified on Monday, June 16 2008.

A 31 man in otherwise good health is standing, engaged in conversation with his brother. In response to a humorous statement, he begins laughing hysterically. Suddenly, he collapses to the ground. He remains awake and alert, but is very weak for several seconds. The most accurate term for this phenomenon is:

 
        A) Complex partial seizure
 
        B) Narcolepsy
 
        C) Non-epileptic seizure
 
        D) Syncope
 
        E) Cataplexy
 

 


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This question was created on June 16, 2008 by jdmiles.
This question was last modified on June 16, 2008.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Complex partial seizure

This answer is incorrect.


There is nothing in this patient's history to suggest epilepsy. He remains awake and alert after collapsing. His history is more consistent with cataplexy.   (See References)

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B) Narcolepsy

This answer is incorrect.


Narcolepsy is a disorder characterized by sudden attacks of irresistible sleep. It is often associated with parasomnias such as sleep paralysis, hypnagogic hallucinations, and cataplexy. Cataplexy is the sudden loss of muscle tone, with preserved consciousness, that this patient has experienced.   (See References)

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C) Non-epileptic seizure

This answer is incorrect.


This person's spell does not resemble a seizure. It is best described as cataplexy.  (See References)

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D) Syncope

This answer is incorrect.


Syncope implies loss of consciousness. This patient has experienced cataplexy.   (See References)

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E) Cataplexy

This answer is correct.


This sudden loss of muscle tone, with preserved consciousness is called cataplexy. Cataplexy usually occurs in response to an emotional stimulus like laughter, although less frequently it can occur without stimulus.   (See References)

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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York. (ISBN:0070674973) Advertising:
2. Green, P.M., and Stillman, M.J. (). "Narcolepsy. Signs, symptoms, differential diagnosis, and management." Arch Fam Med, 7(5) 472-8. (PMID:9755742)
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adult
paroxysmal spells 01
Question ID: 061608058
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 06/16/2008
Modified: 06/16/2008
Estimated Permutations: 8400

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