Infancy onset of symptoms of narcolepsy in a child

Narcolepsy in pediatric age - Experience of a tertiary pediatric hospital

Narcolepsy, a chronic disorder of the sleep–wake cycle of multifactorial etiology, is characterized by excessive daytime sleepiness, often associated with cataplexy, hypnagogic/hypnopompic hallucinations and sleep paralysis. Both early clinical suspicion and therapeutic approach are essential for promotion of cognitive development and social integration of these children. The authors present a descriptive retrospective study of a series of eight children in whom symptoms first started between 6.8 and 10.5 years of age. Diagnostic delay ranged from 4 months to 2 years. One child had H1N1 flu vaccination eight months before the clinical onset. The first multiple sleep latency test was positive in 6 of 8 cases. All cases were treated with methylphenidate, and venlafaxine was associated in 4 of them. In one case the initial therapy was exclusively behavioral. In all cases, symptomatic improvement, better school performance and social integration were achieved after therapeutic adjustment.

Sleep problems in children with neurological disorders

This review describes the complex and often reciprocal relationship between sleep problems, neurological disorders and/or intellectual disability in children. The causes of Intellectual disability (ID) discussed in this review include those conditions present from or around the time of birth, although it also considers traumatic brain injuries occurring later in development. This review discusses the patterns of sleep difficulty associated with specific disorders and summarizes the assessment and interventions, both behavioural and pharmacological, applicable to children. Many neurological disorders such as epilepsy, narcolepsy and neurorespiratory disorders vary considerably in terms of the degree of co-morbid problems and can present with a spectrum of effects on underlying cognitive or behavioural substrates including sleep function. These conditions are discussed as they provide useful insights into how disordered sleep can impact on cognitive development and behaviour. The review draws both on the literature in these areas and the extensive clinical experience of the authors.