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Episodes of muscular weakness which, depending on the severity of the attack, show up as anything from a barely perceptible slackening of the facial muscles to the dropping of the jaw or head, weakness at the knees, or total collapse on the floor. Speech is slurred, eyesight impaired (double vision, inability to focus) but hearing and awareness remain undisturbed. These attacks are triggered by strong emotions such as exhilaration and laughter, anger and surprise. Cataplexy may be most severe when the subject is tired rather than fully alert and can lead to considerable anxiety although anxiety itself is not a trigger The attacks last some minutes and may end in resumption of normal behaviour or the sufferer may slip into sleep sometimes of extended duration.