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Continuous cataplexy in a patient with a midbrain tumor

The limp man syndrome

Department of Neurology, University of California, San Francisco, CA.

A patient with glioblastoma of the rostral brainstem and hypothalamus exhibited bilateral internuclear ophthalmoplegia and vertical nystagmus; he suffered episodes of cataplexy, narcolepsy, and sleep paralysis. A peculiar fluctuation of posture and tone ("limp man syndrome") proved to be a manifestation of continuous cataplexy, as documented by H-reflex recordings. This is the first report of a remarkable movement disorder caused by continuous, fluctuating, partial cataplexy, and is the second report of an association between cataplexy and a tumor of the rostral brainstem.

Address correspondence and reprint requests to Dr. Layzer, Department of Neurology, School of Medicine, University of California, San Francisco, CA 94143.

Accepted for publication January 7, 1980.

Presented in part at the thirty-first annual meeting of the American Academy of Neurology, Chicago, IL, April 1979.

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