Narcolepsy in prepubertal children.
Narcolepsy was diagnosed in 51 children (29 boys). The age range was 2.1 to 11.8 years (mean, 7.9 +/- 3.1 years). A mean of three referrals was made before narcolepsy was considered. In 10 children, cataplexy was the presenting symptom. Thirty-eight children acknowledged sleep paralysis and 30 acknowledged hypnagogic hallucinations. All children had sleep studies; 31 exhibited rapid eye movement at sleep onset. The mean sleep latency was 1.5 minutes +/- 39 seconds on the Multiple Sleep Latency Test. All children had at least two sleep-onset rapid eye movement sleep episodes in this test. Forty-six children were HLA class II-positive for DQw6, and 45 were also positive for DRw15. Thirty (65%) families refused referrals to support and counseling groups. Teachers often refused to acknowledge a medical problem. During follow-up, all children presented at least once with depressive symptoms in reaction to their syndrome. Narcolepsy should be considered when evaluating children with behavioral and depressive symptoms.
Guilleminault
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Stanford Sleep Disorder Clinic, Stanford University Medical Center, CA 94305, USA.
Pelayo
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D001294:Attitude to Health; D002385:Cataplexy / Q000175:diagnosis; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D009290:Narcolepsy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D010290:Parents / Q000523:psychology; D010349:Patient Compliance; D017286:Polysomnography; D011446:Prospective Studies; D011627:Puberty / Q000502:physiology*; D011930:Reaction Time; D012890:Sleep / Q000502:physiology; D012895:Sleep, REM / Q000502:physiology