title: Effects of adenotonsillectomy on neurocognitive function in pediatric obstructive sleep apnea syndrome.
abstract: Obstructive sleep apnea syndrome (OSAS) in children does not only present with symptoms of sleep disturbances but also with associated symptoms such as growth failure, enuresis, academic learning difficulties, and behavioral problems, including attention deficit/hyperactivity disorder- (ADHD-) like symptoms. We evaluated neurocognitive functions before and after adenotonsillectomy in a patient with OSAS. An 11-year-old boy suspected of having ADHD with nocturnal enuresis was referred for evaluation. He was found to have adenotonsillar hypertrophy. Presence of snoring was evident only after detailed medical interview. Polysomnography confirmed the diagnosis of OSAS, which was subsequently treated by adenotonsillectomy. The apnea/hypopnea index decreased from 21.9 at baseline to 1.8 after surgery, and the frequency of enuresis fell from almost nightly to 2-3 times per month. Neurocognitive and behavioral assessment after the treatment of OSAS showed significant improvement in cognitive functions, especially attention capacity and considerable amelioration of behavioral problems including ADHD-like symptoms. As the most common cause of pediatric OSAS is adenotonsillar hypertrophy, medical interview and oropharyngeal examination should always be performed in children suspected of having ADHD. The necessity of sleep evaluation for children with ADHD-like symptoms was also emphasized.
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan.
authors: Fumie
authors: F
authors: Horiuchi
authors: Center for Sleep Medicine, Ehime University Hospital, Ehime, Japan ; Hiroshima Sleep Center, Hiroshima, Japan.
authors: Yasunori
authors: Y
authors: Oka
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan ; Zaidan Niihama Hospital, Niihama, Ehime, Japan.
authors: Kenjiro
authors: K
authors: Komori
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan ; Hiroshima Sleep Center, Hiroshima, Japan.
authors: Yasumasa
authors: Y
authors: Tokui
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan.
authors: Teruhisa
authors: T
authors: Matsumoto
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan.
authors: Kentaro
authors: 0000-0002-6569-7828
authors: K
authors: Kawabe
authors: Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan.
authors: Shu-Ichi
authors: S
authors: Ueno