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Título

Excessive daytime sleepiness in pediatrics, is it correct to think first about narcolepsy? , on the subject of a clinical case of the Children's Institute (ICR) – HCFMUSP

Introdução

Excessive daytime sleepiness or excessive need for sleep is the main symptom of several diseases, and it is generally the cause of various problems in children's daily lives as it has a negative impact on the acquisition of cognitive skills and school performance. By not being correctly interpreted as a health problem by teachers and colleagues, it can also determine a problem in social relationships.

Objetivo

Show the importance of a diagnostic algorithm and the role of new technologies in pediatric patients with excessive daytime sleepiness.

Métodos

We describe a clinical case, with previous suspicion of attention deficit hyperactivity disorder and type 2 narcolepsy, due to excessive daytime sleepiness, learning difficulties, unsatisfactory school performance and school bullying. Case submitted to a clinical investigation, neuropsychological evaluation and the narcolepsy protocol, with the use of actigraphy for 15 days, type 1 polissonography and multiple sleep latencies test.

Resultados

After observing the clinical data and the results of the diagnostic tests, the presence of: phase delayed circadian rhythm disorder, excessive daytime sleepiness, (mean sleep latency of 20 minutes, 5 sleep onset rapid eye movement sleep periods), and in the neuropsychological evaluation were identified depressed mood and attention deficit.

Conclusões

Circadian rhythm disorders cause insufficient sleep, a problem that affects cognitive, emotional and behavior regulation, which can be confused with pathologies such as attention deficit hyperactivity disorder, and narcolepsy, this is frequently aggravated in adolescence. Therefore, early identification of symptoms and an organized clinical and multidisciplinary approach are necessary, relying on new technologies that allow us to better target and study the symptoms of patients, in order to achieve an adequate diagnosis and treatment.

Palavras-chave

Excessive daytime sleepiness, circadian rhythm disorder

Área

Relato de Caso

Instituições

HCFMUSP - São Paulo - Brasil

Autores

HUGO GUSTAVO VEGA ALCIVAR, CAMILA MUNARO MONTEIRO, EDDY ALBERTO BETANCOURT FLORES, FLAVIA ZUCCOLOTTO DOS REIS REQUENA, GRACIELLY PORTE DE OLIVEIRA, JOAO VICTOR VALINHO DE MORAIS, THAINA ROCHA BRAGA MACHADO, LETICIA SANTORO AZEVEDO SOSTER, CLARISSA BUENO