Narcolepsy in prepubertal children

Guilleminault, Christian; Pelayo, Rafael

doi:10.1002/ana.410430125

Cited by 145 publications

(102 citation statements)

References 4 publications

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“…It is also notable that the large majority of the children identified in this study (76%) had onset prior to puberty. This profile contrasts with reports of children from the United States 17,18 and Europe, [19][20][21] where mean age of onset ranges from 9.4-10.3 years old in case series of children, and where the majority of children have onset at or following puberty and rarely prior to 5 years old. [18][19][20][21][22] Referral bias could explain this significantly earlier onset.…”

Section: Group Stratificationcontrasting

confidence: 85%

“…A minor difference was the observation of decreased SOREMP numbers in presumably prepubertal subjects, a difference that may explain the more frequent report of negative MSLT results in the prepubertal population. 11,17 In this population, however, the percent of those with a positive MSLT (mean sleep latency ≤ 8 min, ≥ 2 SOREMPs) overall did not differ across puberty group, thus the MSLT was found to be an adequate diagnostic test in children (Tables 3 and 4). There are case reports on precocious puberty and narcolepsy-cataplexy.…”

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confidence: 78%

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Presentations of Primary Hypersomnia in Chinese Children

Han

et al. 2011

Sleep

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627Childhood Narcolepsy/Hypersomnia-Han et al on the pediatric population could help address issues related to puberty, genetic predisposition, and environmental triggers, and possibly shed light on factors that might delay diagnosis. We report on findings from a pediatric cohort of patients who presented with primary hypersomnia to a sleep clinic in Beijing, China over a period of ~10 years. All were evaluated in a standard fashion and classified as narcolepsy with or without cataplexy or idiopathic hypersomnia. Our purpose was to describe age of onset and clinical features of primary hypersomnia among a mainland Chinese cohort of children, and to compare the findings to the literature. METHODS PatientsPatients were children, defined as < 18 years of age, successively presenting with hypersomnia seen over a period of ~10 years (September, 1998 to May, 2009) at People's Hospital, Beijing University, Beijing. A total of 417 children (63%) were drawn from a population of 671 adults and children with hypersomnia. The hospital has a pulmonary medicine departmentbased sleep center, which sees both children and adults, and receives referrals from all of mainland China. It is estimated that 70% of the diagnosed narcolepsy patients in mainland China are seen at this center at People's Hospitals.12 A prior report focused on the impact of a narcolepsy recognition strategy in a pediatric neurology clinic, 13 whereas this report retrospectively describes a cohort with a broader symptom profile, evaluated using a stan- INTRODUCTIONNarcolepsy-cataplexy (NC) occurs worldwide. In China, there is a population prevalence of 0.034% in patients in South China presenting to sleep centers in Hong Kong 1,2 and a prevalence of 0.014% in Korean adolescents with similar clinical and biological presentations.3-5 Studies in North America and Europe estimates are similar. As the origin and mechanisms that produce narcolepsy are not well understood, comparisons of clinical presentations in collections of several characterized patient groups can inform future studies of clinical and genetic epidemiology.Narcolepsy-cataplexy is said to present in the second to third decade of life, with 70% to 80% of patients reporting onset between 10-20 years of age. Large sample size observations from the United States, Canada, Europe, and Japan report that half of adult patients with narcolepsy report narcolepsy onset prior to 15 years old, and only exceptionally at 5 or younger.6-9 Studies in the 1980s-1990s reported a median delay > 10 years between onset and diagnosis, 10 whereas a more recent report suggests the delay can be only a few years, particularly in children.11 A focus Objective: To retrospectively describe childhood presentations of primary hypersomnia with an emphasis on narcolepsy-cataplexy in a Chinese population. Methods: A total of 417 children (< 18 years old) successively presenting with complaints of hypersomnia without anatomic cause or sleep apnea risk were evaluated using the Stanford Sleep Inventory, human leukocyte antigen (HLA) ...

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Section: Group Stratificationcontrasting

confidence: 85%

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confidence: 78%

Presentations of Primary Hypersomnia in Chinese Children

Han

et al. 2011

Sleep

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“…We might expect an increase as more practitioners become aware of narcolepsy or have the experience of diagnosing someone in their practice. There is the possibility that the condition is, as suggested by others, relatively rare in children when compared to adults; 8 however, that assumption may prove to be untenable. Delayed or mistaken referral diagnoses were common, as the identification of abnormal sleep-wake behavior in children by a non-specialist is believed to be difficult.…”

Section: Discussionmentioning

confidence: 90%

Childhood Narcolepsy in North China

Han

Chen

Wei

et al. 2001

Sleep

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“…However, several more comprehensive publications 11,12,[14][15][16][17][18][19][20][21][22][23] have extended the usual adult descriptions and indicated ways in which the sometimes special features of childhood narcolepsy can cause particular difficulties in its recognition.…”

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confidence: 99%

The protean manifestations of childhood narcolepsy and their misinterpretation

Stores

2006

Developmental Medicine &Amp; Child Neurology

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Narcolepsy often begins in childhood but is infrequently recognized, partly because of its many manifestations that can be confused with other conditions. The clinical presentations of excessive sleepiness, cataplexy, hallucinatory phenomena, and sleep paralysis (not always occurring together) are very varied. The picture may be further complicated by the occurrence of automatic behaviour, memory and visual problems, and associated sleep disorders, as well as the psychological and social consequences of having narcolepsy. Not surprisingly, therefore, misinterpretation of the symptoms as primarily psychological, or otherwise physical, may well occur leading to inappropriate management including initial referral to psychiatric or educational rather than neurological or sleep disorder services. The wide‐ranging and special features of childhood narcolepsy need to be appreciated by health care and other professionals as well as by parents.

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Narcolepsy in prepubertal children

Cited by 145 publications

References 4 publications

Presentations of Primary Hypersomnia in Chinese Children

Presentations of Primary Hypersomnia in Chinese Children

Childhood Narcolepsy in North China

The protean manifestations of childhood narcolepsy and their misinterpretation

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