Functional imaging of cataplexy during status cataplecticus

To identify the neural structures and pathways underlying cataplexy during status cataplecticus in a narcoleptic patient, using brain perfusion single photon emission computed tomography (SPECT). A 68-year-old woman with hypocretin-deficient narcolepsy-cataplexy suffered status cataplecticus after h...

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Bibliographic Details
Published in:Sleep (New York, N.Y.) Vol. 30; no. 2; p. 153
Main Authors: Chabas, Dorothée, Habert, Marie-Odile, Maksud, Philippe, Tourbah, Ayman, Minz, Michel, Willer, Jean-Claude, Arnulf, Isabelle
Format: Journal Article
Language:English
Published: United States 01.02.2007
Subjects:
Aged
Brain - anatomy & histology
Brain - diagnostic imaging
Brain - metabolism
Cataplexy - classification
Cataplexy - diagnosis
Cataplexy - diagnostic imaging
Electroencephalography
Female
Humans
Intracellular Signaling Peptides and Proteins - deficiency
Magnetic Resonance Imaging
Neuropeptides - deficiency
Orexins
Severity of Illness Index
Sleep, REM - physiology
Subtraction Technique
Tomography, Emission-Computed, Single-Photon
ISSN:0161-8105
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Summary:To identify the neural structures and pathways underlying cataplexy during status cataplecticus in a narcoleptic patient, using brain perfusion single photon emission computed tomography (SPECT). A 68-year-old woman with hypocretin-deficient narcolepsy-cataplexy suffered status cataplecticus after having stopped clomipramine. She underwent a 99mTc-ethylcysteinate dimer brain SPECT during an episode of cataplexy; this image was compared with her brain SPECT during an intervening asymptomatic period. Subtraction SPECT coregistered to magnetic resonance imaging (MRI)(SISCOM)-determined anatomic areas differentially perfused during cataplexy and basal wakefulness state. The areas hyperactivated during cataplexy corresponded on brain MRI with the cingular area, the left and right orbitofrontal cortex, the right temporal cortex, and the right putamen. No significant hypoperfused region was observed during the cataplectic episode. Cataplexy during status cataplecticus partially resembles normal rapid eye movement sleep (with high cingular, orbitofrontal, and putamen activity) but without the other imaging characteristics of this state (no hyperactivation of the pons, amygdale, or occipital cortex).
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ISSN:0161-8105
DOI:10.1093/sleep/30.2.153