Case Studies in Sleep Neurology: Common and Uncommon by Antonio Culebras

By Antonio Culebras

Sleep problems are more and more famous as a tremendous medical challenge, with major morbidity and enormous monetary significance. This compendium of case experiences provides a various variety of occasions which problem the problem-solving talents of all these attracted to sleep problems, protecting either universal and strange instances. every one case starts with a medical heritage, by way of exam findings and exact investigations and culminating in prognosis, remedy and administration, with dialogue of differential prognosis the place applicable. Focusing recognition at the significant different types of sleep drugs, together with insomnia, hypersomnias, sleep-breathing issues, parasomnias, flow problems, circadian dysrhythmias and the neurology of sleep, this medical advisor promotes integrative pondering and diagnostic ability. ancient and evaluation citations, illustrations and concise real-life tales stimulate reminiscence and facilitate studying. Written and edited by means of a global cadre of sleep pros, this publication will tell and problem validated experts and supply a stimulating instructing software for these in education.

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Follow-up The patient was referred to an otolaryngologist. Both residual adenoidal and tonsillar hypertrophy were deemed to be the cause of the sleep-disordered breathing. Revision of the adenoidectomy and tonsillectomy were done. The patient’s symptoms and O2 saturation improved immediately thereafter. A follow-up sleep study 2 months later revealed that the patient no longer demonstrated an obstructive breathing pattern or impairment in gas exchange. General remarks Obstructive sleep apnea (OSA) in infants and young children has unique features.

Other etiologies include congenital anomalies, especially those involving midfacial hypoplasia or a small nasopharynx or micrognathia, obesity, laryngomalacia and neuromuscular disorders involving muscular hypotonia or hypertonia. In contrast, OSA in adults occurs most commonly as a result of obesity. The clinical manifestations of OSAS in older children include continuous snoring, difficulty breathing while asleep and restless sleep. Parents are usually concerned and report loud snoring and retractions.

Nature 2006; 441: 589–94. Morgenthaler TI, Kapur VK, Brown T, et al. Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep 2007; 30: 1705–11. Nevsimalova S. Narcolepsy in childhood. Sleep Med Rev 2009; 13: 169–80. Case 6 A sleepy-head Antonio Culebras Clinical history Mr. X. remembered being a sleepy-head in high school. He would sleep through study hall and had great difficulty staying awake in morning classes.

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