Question

A patient comes into the emergency room complaining that twice during the past week he experienced a sudden loss of muscle tone. The first time occurred when he was told that his mother was diagnosed with cancer. The second came during a track meet while he was warming up before his turn to run. These episodes are most likely to be associated with which one of the following diagnoses?

A. Obstructive sleep apnea hypopnea
B. Insomnia disorder
C. Hypersomnolence disorder
D. Narcolepsy
E. Circadian rhythm sleep-wake disorder

Answer 1

The patient's experience of sudden muscle tone loss during emotional situations or routine activities suggests a diagnosis of Narcolepsy, particularly due to the symptoms of cataplexy associated with the disorder.

Step-by-step explanation:

A patient coming into the emergency room complaining of a sudden loss of muscle tone during emotionally charged incidents or during normal activities is most likely experiencing symptoms associated with Narcolepsy.

This sleep disorder is not just characterized by an irresistible urge to sleep, but also by cataplexy, which is the sudden and temporary loss of muscle tone.

This patient's experience upon hearing upsetting news and during a sporting event aligns with these symptoms of narcolepsy, particularly cataplexy that can be triggered by strong emotions like laughter, excitement, or stress. Other sleep disorders, such as obstructive sleep apnea and insomnia, present different symptoms such as difficulty breathing during sleep and trouble falling or staying asleep, respectively.

Therefore, the correct diagnosis in this scenario is 'D. Narcolepsy'.