Cataplexy in association with meningiomas

Cataleptic attacks or atonic seizures have been described in cases of frontal lesions due to meningiomas. Five new cases are reported: 3 frontal and 2 parietal meningiomas. In 3 of the cases the attacks started before removal of the tumours. A consecutive case-material of 66 intracranial meningiomas verified neurosurgically was re-examined. Only 2 patients had cataleptic attacks and were included among the 5 cases reported. Both had a parietal convexity meningioma. Although most cases of cataleptic attacks after the age of 50 probably are of vascular origin, the possibility of a frontal or parietal meningioma should be considered. It is suggested that the cataleptic attacks in these cases are caused by 'weak' epileptic discharges spreading along the cortico-reticular fibres and activating the motor inhibitory reticulo-spinal pathways.