title: Narcolepsy-cataplexy and loss of sphincter control.
abstract: We describe the case of a 34-year-old man who presented intermittent faecal incontinence as a manifestation of cataplexy. The patient's sleep history was positive for the full narcoleptic tetrad (sleep attacks, cataplexy, sleep paralysis and hypnagogic hallucinations) while extensive neuropsychiatric work up was negative for any neurologic or psychiatric illness. Repeat polysomnograms (including a polysomnogram with a full seizure montage) were positive for pathologic sleepiness, but there was no evidence of a seizure disorder. The course of the patient's symptomatology and the favourable response of his symptoms to stimulants and imipramine support the theory that his intermittent loss of sphincter control is part of his narcolepsy-cataplexy.
authors.affiliation: Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
authors.forename: A N
authors.initials: AN
authors.lastname: Vgontzas
authors.forename: S E
authors.initials: SE
authors.lastname: Sollenberger
authors.forename: A
authors.initials: A
authors.lastname: Kales
authors.forename: E O
authors.initials: EO
authors.lastname: Bixler
authors.forename: A
authors.initials: A
authors.lastname: Vela-Bueno
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002385:Cataplexy / Q000150:complications* / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D005242:Fecal Incontinence / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007099:Imipramine / Q000627:therapeutic use; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D009290:Narcolepsy / Q000150:complications* / Q000188:drug therapy
chemical_list: D000929:Antidepressive Agents, Tricyclic; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D007099:Imipramine