title: A video-polygraphic analysis of the cataplectic attack.
abstract: OBJECTIVE
  To perform a video-polygraphic analysis of 11 cataplectic attacks in a 39-year-old narcoleptic patient, correlating clinical manifestations with polygraphic findings. Polygraphic recordings monitored EEG, EMG activity from several cranial, trunk, upper and lower limbs muscles, eye movements, EKG, thoracic respiration.
  
  
  RESULTS
  Eleven attacks were recorded, all of them lasting less than 1 min and ending with the fall of the patient to the ground. We identified, based on the video-polygraphic analysis of the episodes, 3 phases: initial phase, characterized essentially by arrest of eye movements and phasic, massive, inhibitory muscular events; falling phase, characterized by a rhythmic pattern of suppressions and enhancements of muscular activity, leading to the fall; atonic phase, characterized by complete muscle atonia. Six episodes out of 11 were associated with bradycardia, that was maximal during the atonic phase.
  
  
  CONCLUSIONS
  Analysis of the muscular phenomena that characterize cataplectic attacks in a standing patient suggests that the cataplectic fall occurs with a pattern that might result from the interaction between neuronal networks mediating muscular atonia of REM sleep and neural structures subserving postural control.
authors.affiliation: Department of Neurological Sciences, Bellaria Hospital, University of Bologna, Via Altura, 3 - 40139, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rubboli
authors.forename: G
authors.initials: G
authors.lastname: d'Orsi
authors.forename: A
authors.initials: A
authors.lastname: Zaniboni
authors.forename: E
authors.initials: E
authors.lastname: Gardella
authors.forename: M
authors.initials: M
authors.lastname: Zamagni
authors.forename: R
authors.initials: R
authors.lastname: Rizzi
authors.forename: S
authors.initials: S
authors.lastname: Meletti
authors.forename: F
authors.initials: F
authors.lastname: Valzania
authors.forename: A
authors.initials: A
authors.lastname: Tropeani
authors.forename: C A
authors.initials: CA
authors.lastname: Tassinari
mesh_terms: D000328:Adult; D002385:Cataplexy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009290:Narcolepsy / Q000503:physiopathology*; D017286:Polysomnography / Q000379:methods*; D011187:Posture / Q000502:physiology; D014741:Video Recording