Morkous Sameh S
Pediatric Neurology, Lehigh Valley Reilly Children's Hospital, Allentown, USA.
Pediatrics, Philadelphia College of Osteopathic Medicine & DeSales University, Allentown, USA.
Cureus. 2020 Dec 4;12(12):e11893. doi: 10.7759/cureus.11893.
A 10-year-old female presented to the sleep clinic for a second opinion about her epilepsy diagnosis. She had been treated with antiepileptic medication but her events persisted. The child would wake up several times every night speaking nonsense words, appear confused to her family, and then go back to sleep. A video of the polysomnography (PSG) showed the patient having two of her typical events. The patient was eventually diagnosed with confusional arousal (CoA) secondary to obstructive sleep apnea (OSA). The nocturnal events resolved after her OSA was treated. This case highlights an atypical clinical presentation for a type of parasomnia like CoA that was misdiagnosed and treated for seizures. It will illustrate OSA and its mechanisms as a potential occasional treatable cause for CoA. It also demonstrates the importance of video-PSG in the work-up of CoA.
一名10岁女性前往睡眠诊所，就其癫痫诊断寻求第二种意见。她一直在接受抗癫痫药物治疗，但症状仍持续存在。该患儿每晚都会醒来几次，说着胡话，家人觉得她很困惑，然后又重新入睡。多导睡眠图（PSG）视频显示患者出现了两次典型症状。该患者最终被诊断为阻塞性睡眠呼吸暂停（OSA）继发的混乱觉醒（CoA）。治疗其OSA后，夜间症状得到缓解。该病例突出了一种类似CoA的异态睡眠的非典型临床表现，其最初被误诊为癫痫并接受了相应治疗。它将阐明OSA及其作为CoA潜在的偶尔可治疗病因的机制。它还证明了视频PSG在CoA检查中的重要性。
