If you are familiar with my writing, you know that I think strep infections are a big cause of Narcolepsy. My main thesis is that chronic long-term infection causes less orexin production, orexin cell destruction and drastic metabolic changes that we experience as sleep, eating and mood disorders.
But I haven't really had a good explanation for how a systemic infection could cause cataplexy. A constant low level of orexin doesn't really account for the sudden onset of cataplexy.
I read something that flipped a switch in my brain though.
Look at this:
The Vagus Nerve Infection Hypothesis for Chronic Fatigue Syndrome
Location, Location, Location.
VanElzakker proposes that an infection triggers CFS, but if his theory is right the most important thing about that infection is not what it is but where it is. That ‘where’ is the biggest nerve in the body; the vagus nerve – a ‘wandering nerve’ that stretches over much of our torso and sends its roots into most of the organs of the body.
The vagus nerve isn’t just any nerve; it’s the nervous system’s immune conduit to the brain. VE believes that an infection there doesn’t need to be large to cause havoc in the brain; it just needs to be present.
This may be what is going on with cataplexy.
Strep infections result in chronic throat biofilms from either nasal or tonsillar ulcers. Pathogenic bacteria create mucous coverings in the throat near the ear canals. And these persistent colonies are antibiotic resistant.
The branches of the vagus nerve run down both sides of your neck, They run right next to the ears and down the front of your chest and all through your abdomen.
The vagus nerve controls a lot of things. Your heart rhythm, your digestion, all the way down to your reproductive organs. Not to mention it is wired to the Locus Ceruleus in the brain- which triggers cataplexy.
I am pretty convinced that if you have a chronic biofilm near the ears, the bacteria can infiltrate and affect the nerve- and when you stimulate the the nerve via stress, you trigger a neurological short-circuit.
Orexin cells also directly control heart rhythm by direct contact with the Vagus. I would guess this causes that feeling that someone is sitting on your chest during panic attacks. And maybe some of the heart fluttering that happens when we're hypoglycemic.
Anyhow- the Vagus nerve is in the throat. It seems to cause the panic problems.
Trigeminal nerve is in the nose and mouth. Infections in those places seem to cause the headaches and hallucinations.
(For the record, a good portion of my certainty comes from attending Narcolepsy conferences. I watch the audience. In one afternoon session, at least 80% of the zombies were rubbing their necks behind the ear, the others were asleep. We also tend to pierce our ears and faces a lot.)
Vagal Stimulating Devices are all the rage these days. I think that might be promising.
But you should probably try this first.