Kotagal Suresh
Division of Child Neurology and the Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Curr Opin Pediatr. 2008 Dec;20(6):659-65. doi: 10.1097/MOP.0b013e328316bd9d.
To enhance the ability of the practitioner to diagnose and manage children with parasomnias in the office setting.
Over 80% of preschool-age children experience parasomnia events. Instability in the regulation of sleep continuity might underlie sleep walking, sleep terrors, and confusional arousals. Catathernia or nocturnal groaning is a parasomnia that is recognized in adults but frequently has onset during childhood.
Common childhood parasomnias such as hypnic starts, rhythmic movement disorder, sleep paralysis, confusional arousals, sleepwalking, sleep terrors, enuresis, and nightmares are discussed. These events may lead to significant concern and worry for the parents. Most parasomnias are recognizable by history alone, but some may require nocturnal polysomnography for accurate diagnosis and determining an underlying trigger factor. Findings on nocturnal polysomnography are described. Sleep terrors, confusional arousals and sleepwalking may mimic seizures; distinguishing seizures from parasomnias is discussed. There is a genetic predisposition to many childhood parasomnias. Management techniques, including behavioral therapy, are reviewed. Unfortunately, evidence-based recommendations are as yet unavailable. The management of sleep enuresis continues to remain a significant challenge.
提高从业者在门诊环境中诊断和管理患有异态睡眠儿童的能力。
超过80%的学龄前儿童经历过异态睡眠事件。睡眠连续性调节的不稳定可能是梦游、夜惊和混乱觉醒的基础。猝倒或夜间呻吟是一种在成人中被认识到但常在儿童期起病的异态睡眠。
讨论了常见的儿童异态睡眠，如梦魇起始、节律性运动障碍、睡眠麻痹、混乱觉醒、梦游、夜惊、遗尿和噩梦。这些事件可能会引起家长的极大关注和担忧。大多数异态睡眠仅通过病史即可识别，但有些可能需要夜间多导睡眠图来进行准确诊断并确定潜在的触发因素。描述了夜间多导睡眠图的结果。夜惊、混乱觉醒和梦游可能会模仿癫痫发作；讨论了如何将癫痫发作与异态睡眠区分开来。许多儿童异态睡眠存在遗传易感性。回顾了包括行为疗法在内的管理技术。不幸的是，目前尚无基于证据的建议。遗尿的管理仍然是一个重大挑战。
