title: Narcolepsy with obstructive sleep apnea in a 4-year-old Korean girl: a case report.
abstract: A 4-yr-old girl has exhibited severe snoring, restless sleep and increasing daytime sleepiness over the last 3 months. The physical examination showed that she was not obese but had kissing tonsils. Polysomnography demonstrated increased apnea-hypopnea index (AHI) of 5.2, and multiple sleep latency tests (MSLT) showed shortened mean sleep latency and one sleep-onset REM period (SOREMP). She was diagnosed with obstructive sleep apnea (OSA) and underwent tonsillectomy and adenoidectomy. After the surgery, her sleep became much calmer, but she was still sleepy. Another sleep test showed normal AHI of 0.2, the mean sleep latency of 8 min, and two SOREMPs. Diagnosis of OSA to be effectively treated by surgery and narcolepsy without cataplexy was confirmed. Since young children exhibiting both OSA and narcolepsy can fail to be diagnosed with the latter, it's desirable to conduct MSLT when they have severe daytime sleepiness or fail to get better even with good treatment.
authors.affiliation: Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Korea.
authors.forename: Soonhak
authors.initials: S
authors.lastname: Kwon
authors.forename: Kyungmi
authors.initials: K
authors.lastname: Jang
authors.forename: Sukyung
authors.initials: S
authors.lastname: Hwang
authors.forename: Minhyun
authors.initials: M
authors.lastname: Cho
authors.forename: Hyeeun
authors.initials: H
authors.lastname: Seo
mesh_terms: D000233:Adenoidectomy; D044466:Asian People; D002675:Child, Preschool; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use; D009290:Narcolepsy / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017286:Polysomnography; D056910:Republic of Korea; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D014068:Tonsillectomy
chemical_list: D008774:Methylphenidate
keywords: Children; Narcolepsy Without Cataplexy; Obstructive Sleep Apnea