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Trastornos del sueno en niños.
Abstract
En este artículo se revisan los principales trastornos del sueño, en particular aquéllos que son más frecuentes durante la infancia. subrayando su vinculación al desarrollo neuropsicológico del niño. Tras una breve exposición de las características del sueño normal y de sus mecanismos neurofisiológicos, se describen los distintos trastornos del sueño y se exponen la utilidad del estudio en el laboratorio de sueño para cada uno de ellos.
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Many patients complain of difficulty initiating or maintaining sleep, or excessive daytime sleepiness. Since specific treatments exist for some disorders, accurate diagnosis is important. Causes of sleep disturbances may be medical or psychiatric, and a behavioral component is apparent in some cases. Indications for referral to a sleep evaluation center are discussed.
Narcolepsy is rarely diagnosed in preteenaged children. Its clinical and polysomnographic manifestations, some of which are unusual, are described in four children who were observed prospectively. The mean age at onset of hypersomnia was 10.2 years (range 8.4 to 11.2 years). Daytime naps among these children were lengthy, ranging from 20 to 120 minutes, and generally were considered unrefreshing. Cataplexy was present at the onset in all four children. Three of the four children were obese, with the concurrent nocturnal snoring prompting a misleading concern about obstructive sleep apnea syndrome in two children. The histocompatibility DR2 antigen was present in all four children. Significant behavioral manifestations appeared in all of them. The response to stimulant medications was, at best, modest. Narcolepsy may be difficult to diagnose in this age group. However, a careful history eliciting sleep/wake dysfunction (including cataplexy), leukocyte assays for the histocompatibility DR2 antigen, and serial polysomnographic studies may enable early recognition and treatment of this disease.
Jactatio capitis nocturnus, or sleep-related head banging, is a sleep abnormality consisting of to-and-fro head rocking, or less commonly of total body rocking, occurring just before or during sleep. It is usually noted in the immediate presleep period and is sustained into light sleep. It is uncommon for it to occur in deep NREM sleep. The following is an unusual case of jactatio capitis nocturnus.
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