Monday, November 2, 2015


Too bad I missed Halloween. But here's a related case.

A preschool-aged child is brought in by his parents who worry about behaviors in his sleep. During the early part of the night, he often awakes abruptly with a loud scream. He is agitated, flushed, sweating, and tachycardic. Once, he even jumped out of bed. When his parents try to calm him, he apparently is unaware. He doesn't remember these episodes afterwards. His past medical history includes a work-up for obstructive sleep apnea; he is being evaluated by an otolaryngologist for potential tonsillectomy.

Challenge: What is going on here?

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Anonymous said...

Serotonin syndrome due to administration of SSRI's for Obstructive sleep apnoea

Craig Chen said...

nice guess - i don't have too much experience with SSRIs for OSA; here, OSA is just a risk factor and not directly implicated in the diagnosis.

Sleep terror is the most common type of parasomnia in children. This is associated with incomplete arousable from non-rapid eye movement sleep.

Sources: UpToDate; Wikipedia.