Stimulants an option for cataplexy

Stimulants an option for cataplexy Peter gott, M.D.

PETER GOTT

Reader with a neurological disorder asks Dr. Gott if it has a cure.

United Media

Dear Dr. Gott: I have been diagnosed with cataplexy. Why me? Is there a cure?

Dear Reader: Cataplexy, a peculiar neurological disorder of unknown cause, is marked by cyclic, momentary paralysis that occurs in association with sudden and extreme emotional reactions, such as anger, fear or joy. The weakness, which is brought on by surprise, may be confined to the limbs or may affect the entire body, leading to temporary collapse. The most common illustrations of cataplexy are 1) people who experience transient weakness while laughing or crying, and 2) the fisherman who uncontrollably drops his rod when a fish strikes.

Many authorities believe that cataplexy is a form of narcolepsy, a similar neurological affliction marked by unexpected, recurrent attacks of sleep that occur at inappropriate times.

The conditions are diagnosed during studies of patients' sleep patterns that show a characteristic abnormality, consisting of sudden bursts of rapid-eye-movement (REM) sleep.

Ordinarily, occasional cataplectic attacks can be ignored. More severe forms are treated with stimulant drugs such as Dexedrine. Patients with sleep disorders should be under the care of neurologists.

To give you related information, I am sending you a copy of my Health Report "Sleep and Wake Disorders." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Why do doctors no longer check the carotid arteries when doing a routine exam? I've always believed that the check is important, but my doctor doesn't agree.

Dear Reader: In my experience, most good doctors do check the pulsations in the carotid arteries. This takes only a second or two. These arteries lie on either side of the trachea (windpipe) in the neck and can easily be palpated at the same time that the careful physician feels the thyroid gland, additional tissue that should also be periodically examined.

Obviously, the issue here is frequency. If you are in your 20s and enjoy good health, you do not need to have frequent examinations of your carotid arteries. On the other hand, if you're over 50, your carotids should be checked whenever you have a routine exam every year or two.

In addition, the doctor will probably listen to the arteries with a stethoscope, because slight, age-related blockages in the carotids often produce a "whooshing" sound called a "bruit." If a blockage is present, it should be monitored with other tests, such as a Doppler ultrasound. As you know, carotid plaques increase the risk of stroke, so - depending on your age - the carotid exam is important and should be considered routine.

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