Catalepsy: Causes, Symptoms and Treatment

The catalepsy Is a disorder of the central nervous system characterized by a momentary and involuntary loss of mobility, the patient adopting a rigid posture. Consciousness may be intact, or altered to varying degrees. For example, the individual may feel that he is unable to move his body or ask for help, being fully aware of what is happening around him.

The word catalepsia comes from the medieval Latin catalēpsia, which in turn comes from the Greek katalepsis, which means"to grasp"or"grasp."

catalepsy

During catalepsy, the body is immobile and does not respond to stimuli, with limbs flaccid or rigid. Breathing is so gentle that it may appear that you are not breathing and heart rate can be almost impossible to detect without special medical equipment.

In short, the patient has very weak vital signs so it is easy to believe that he has died if not inspected by professionals. In fact, there are numerous legends that tell that in antiquity they have come to bury living people who only suffered periods of catalepsy, thinking that they had died.

Catalepsy is very typical of psychiatric disorders such as schizophrenia or psychosis. It is also associated with Parkinson's , the epilepsy And the abuse of certain drugs that can produce it as a secondary symptom.

Regarding the prevalence of catalepsy in the population and the specific diagnostic criteria for detecting it, there are no data at present. The phenomenon is mainly studied in laboratory animals, especially in rats.

Causes of catalepsy

Catalepsy has multiple causes and is associated with a variety of conditions. What is known is that it is produced by alterations in physiological mechanisms of the organism. In particular, it is associated with diseases that affect Basal ganglia And extrapyramidal pathways.

Therefore, this condition may present as a symptom of neurological conditions such as Parkinson's and epilepsy.

It is also linked to the depression Yet the schizophrenia Treated with Antipsychotic medications As the Haloperidol . This drug blocks the Dopamine Of the brain, which in the long term can alter the motorways, so it is not surprising that it increases the probability of suffering catalepsy.

Treatment with drugs that inhibit adrenergic neurotransmitters (such as Reserpine ), Have also been linked to catalepsy.

This is because an important blockade of these neurotransmitters causes hypotension and an increase of Acetylcholine . This substance acts on motor functions, so it can induce the symptoms of catalepsy.

Drugs can also produce this condition, mainly abstinence from cocaine In addicts and anesthesia with Ketamine .

Experiments with animals have shown that cocaine use promotes catalepsy, especially at high doses. According to Gutiérrez Noriega and Zapata Ortiz, it is possible that cocaine catalepsy is due to an extremely intense excitation of the nerve centers, which is even greater than the motor agitation.

In a review by the University of Navarra, it is concluded that the motor symptoms of catalepsy are due to an alteration in the dopaminergic, serotonergic and glutaminergic regulation of the Basal ganglia .

The deficiency of Protein kinase A (PKA) also appears to influence the symptoms of catalepsy (Adams et al., 1997).

There are authors who claim that catalepsy could have a hereditary basis. Apparently, there is a genetic predisposition to catalepsy, monogenic transmission. Specifically, it is located on a fragment of chromosome 13, which contains the serotoninergic 5HT1A receptor gene.

In other cases, it is said that catalepsy can occur after a very strong emotional shock, although it is not entirely clear why.

Risk factors that may increase the likelihood of catalepsy are: abstinence from psychostimulants after having used them chronically, Selective Serotonin Reuptake Inhibitors (SSRIs) And stress (if susceptible to catalepsy).

symptom

Catalepsy is characterized by the following symptoms:

- Total loss of control of voluntary and involuntary movements. That is, the person is in a state of complete immobility.

- Muscle stiffness and posture.

- Some decrease of the sense of the touch, with a reduction of the sensitivity to the pain.

- Lack of responses to stimuli.

- The limbs remain in the same position when they are moved (what is called Wax flexibility )

- Breathing and pulse very slow, almost imperceptible.

- Reduction of bodily functions.

- Paleness, so much that it can be believed that the person is dead.

Catalepsy should not be confused with...

The catalepsy must be distinguished from the terms Cataplexy , Catatonia or narcolepsy.

The Cataplexy or cataplexy Is distinguished by sudden and brief episodes of loss of muscle tone that causes the person to collapse on the floor. In cataplexy, consciousness remains totally lucid. It is very typical in some forms of epilepsy and in narcolepsy.

However, the Catatonia Occurs when there are certain motor abnormalities along with alterations of consciousness. It stands out for an apparent lack of response to external stimuli, muscular rigidity, fixed gaze and opposition to obeying instructions. It is a symptom closely linked to schizophrenia And autism.

On the other hand, Narcolepsy Is a sleep disorder characterized by excessive daytime sleepiness and sleep attacks. It may or may not be accompanied by catalepsy.

Treatment

As mentioned above, catalepsy is not a disease itself, but is the consequence of other disorders. Therefore, the treatment will be aimed at improving these conditions.

For example, establishing treatments for Parkinson's or epilepsy, drug detoxification in the case of addiction, or if the drugs are the cause, change them for others that do not have those secondary symptoms.

Thus, if it is due to drug abuse or drug effects, it is best to discontinue the administration of these as soon as possible and catalepsy will cease within a few days.

When it is a consequence of mental illness, it requires psychological and / or psychiatric care as soon as possible.

If, on the contrary, catalepsy is due to the experimentation of extreme emotions, it normally disappears by itself in a very short time.

In other cases, the preferred treatment is usually of the pharmacological type. For some people, muscle relaxants or Barbiturates . They also seem to be effective Antidepressants Specific noradrenergic and serotonergic. In addition, chronic caffeine consumption may be a protective factor against catalepsy.

On the other hand, in prolonged periods of catalepsy, it is important to take care of the patient's skin. It will be necessary to move the muscles of this one to avoid problems of circulation, as well as to change of position to the affected one from time to time.

As in many cases these patients are aware, it is advisable that relatives or loved ones accompany you to feel more relaxed.

Catalepsy and the fear of being buried alive

Fortunately, confirmation of any death by a qualified medical practitioner before proceeding to the burial is now mandatory by law. However, this has not always been the case.

In the 1st century AD Pliny the Elder affirmed in his work"Natural History"that, in spite of having external signs that indicate the death, none assures it completely.

The Greek physician Galen also pointed out how complex it was to establish someone's death when suffering from suffocation, hysteria, alcoholic intoxication, or, of course, catalepsy.

In spite of the scientific advances, in century XVII the death remained surrounded in a halo of mysticism and the procedure to certify the death remained the same from the old Rome. That is, the absence of heart beats, lack of breathing and degree of sensitivity were checked.

In the eighteenth and nineteenth centuries spread to Europe and the United States the fear of being buried alive. Many people left in their testament indications to avoid their burial ahead of time. This seemed to have some basis, for in 1749 the French physician Jean-Jacques Bruhier claimed to have found 56 cases of people buried alive.

Another factor that promoted this belief were the statements of the physician François Thiérry at the end of the eighteenth century. He noted that about one-third to one-half of the deaths were detected incorrectly, with the body still alive when buried.

In the twentieth century researchers William Tebb and E.P. Vollum published a study in which they affirmed that 161 people had been buried alive. They thought about the strange positions that many bodies showed when they were exhumed.

The progress of science and medicine has led to the abandonment of these beliefs, since it is almost impossible that all vital signs are not correctly verified.

In spite of the above, cases have been known in which some people who considered themselves deceased were awakened later during the wake. However, it is believed that these stories are real in a minority. They seem to be mainly popular legends that have not been proven, which have spread through literature and film.

Catalepsy and literature

Catalepsy has been treated by many writers and for some reason has received much attention in the literature. Here are some authors who have spoken about her in her books:

- George Eliot: In his work"Silas Marner: Rave's Shepherd", describes the main character as a middle-aged man who had catalepsy attacks. He is believed to have emerged in his teens when he was falsely accused of being a thief, forcing him to leave his hometown.

- Edgar Allan Poe: In his short story"The Premature Burial", tells a story based on the typical fear of being buried alive. In the work it is said that: "For several years I suffered attacks from that strange disorder that doctors have decided to call catalepsy, in the absence of a name that best defines it."

It describes the disorder explaining that the patient stays in a sort of"exaggerated lethargy"during a period. And although it is unconscious and immobile, the pulsations of the heart remain very weak, as well as other vital signs. For this reason, medical tests can not determine a difference between that state and absolute death.

In another story, as in"The Fall of the Usher House,"he attributes catalepsy to one of his characters: Madeleine Usher. The same happens in the story"Berenice".

- Alexandre Dumas: The abbe Faria, a character from"The Count of Monte Cristo"suffered catalepsy.

- Arthur Conan Doyle: In his work"The Inner Patient"tells how a man fakes a catalepsy attack to access Dr. Treveyan, a neurologist specializing in catalepsy.

- Charles Dickens: In"The Desolate House", tells how one of his characters has violent spasms and "Falls into catalepsy, and you have to climb it up the narrow staircase like a grand piano."

- Émile Zola: In an account of his book"The Art of Dying", which is called"The Death of Olivier Bécaille", the protagonist tells the story of his own death and burial, stating: "Every time I saw more clearly what was happening to me: it must have been a case of those of catalepsy I had heard of."

References

  1. Adams, M.R., Brandon, E.P., Chartoff, E.H., Idzerda, R.L., Dorsa, D.M., & McKnight, G. S. (1997). Loss of haloperidol induced gene expression and catalepsy in protein kinase A-deficient mice. Proceedings of the National Academy of Sciences, 94 (22), 12157-12161.
  2. Catalepsy. (S.f.). Recovered on December 14, 2016, from the University of Salamanca.
  3. Catalepsy. (S.f.). Retrieved on December 14, 2016, from Wikipedia.
  4. Catalepsy. (2015). Retrieved on December 14, 2016, from Good Therapy.
  5. Cepeda, J.L. Catalepsy: Concept and Physiology. University of Navarra End-of-Grade Work.
  6. Grosu, C., & Popescu, C.D. (2015). Catalepsy: then and now. Bulletin of Integrative Psychiatry, 21 (1), 35-42.
  7. Gutiérrez-Noriega, C., & Zapata Ortiz, V. (1945). Experimental catalepsy produced by Cocaine. Revista Peruana de Medicina Experimental y Salud Pública, 4 (4), 268-283.
  8. Kondaurova, E. M., Bazovkina, D. V., & Kulikov, A. V. (2016). Studies of Catalepsy and Other Forms of Behavior Using Recombinant Mouse Strains. Neuroscience and Behavioral Physiology, 46 (9), 992-996.
  9. Catalypsy and Narcolepsy. (November 22, 2013). Obtained from Doctor Cisneros.


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