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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 24 male in otherwise good health is standing, talking to his sister. 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) Syncope

B) Non-epileptic seizure

C) Hypnagogic paralysis

D) Near-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) Syncope

This answer is incorrect.

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


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B) 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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C) Hypnagogic paralysis

This answer is incorrect.

Hypnagogic paralysis refers to a brief period of complete paralysis while a person is falling asleep. This gentleman was awake during his spell, which is better described as cataplexy. (See References)


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D) Near-syncope

This answer is incorrect.

This patient's history is consistent with cataplexy. There is no indication that he was about to lose consciousness as a result of decreased cerebral perfusion, which is what the term near-syncope implies. (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