sleep disorder/add/neurology

[Julie Walsh]

my 6yr old had febrile seizures at 18 mo, and then started night terrors. The sleep problems have gotten more complex; some are terrors, sometimes he will sleepwalk, and often he acts out his dream. He is not scared or anything, he's just participating in a dream as if the people he's talking to are really there (beyond sleep-talking -he's up and moving). When it was almost exclusively night-terror-like, at 3, and he could vocalize, he described myself or a man coming after him with a knife (I don't know where he gets the images..). Keeping it quite cold in his room can head off the night terrors, in summer or if it's warm, then they'll happen 5 nights of 7.  He's had 3 sleep-deprived EEGs all with the results: abnormal, unknown clinical signifigance. Whether or not he's had a sleep-event, there are some mornings (2-3 per wk or so) where he gets up and you'd think he never slept. he has bags under his eyes and he can't cope at all. it's always been like that - he had to nap up until school started. now he's having behavioural probs in school - almost ADHD-like, except he can attend and focus, and that it depends on the day cuz some days he's just fine. he's been refered to a neurologist for a video eeg (?is this the o/n sleep one?).  are there questions I should ask the neurologist? other information I should examine? He's very bright, but starting to fall behind emotionally, and since he's been having problems in school, he's started speaking so negatively about himself: 'i'm bad'.'i'm stupid','i can't learn to listen'..... what is going on here? and how can i help my son?

[Julie Walsh]

Just a follow-up:
right now based on his symptoms, they think he has narcolepsy - which symptoms manifest somewhat differently in children than adults. The couple of comments you made regarding your grandson suggest to me that you may want to look at those areas for his needs.

[mlb]

To B.Fowler, who suggest vit.B12 (but is 45, so doesn't know if it would have helped when a youngster):  Because my grandson had a maple smell in his diapers for a short while, we feared Maple Syrup Uninary Disease.  He has been through so many tests (blood, urine, tissue) at various locations.  Cleveland Clinic turned out to be another dead end ("go home and don't worry about him.")  Anyway, the doctors in Pennsylvania have noted that something is off in his gene's, but they also can't pinpoint the significance of it.  At least they sent the parents home with a warning about danger indications in the future and what to do if they present.  The point is, they brought up the sleep/tiredness, and the doctors checked for physical reasons (iron, B12, the whole bit) and found nothing.

To Everyone:  How are the other family members (especially when they were kids?)

[bcrfowler]

This might be a long shot, but I'm 45 years old.  I had the night terrors when I was 2-5yrs. and I walked in my sleep, and talked.  I have always had trouble sleeping other places.  I have had sleep problems (couldn't sleep) different times in my life.  I now have found out I have vitamin B12 deficiency (symptoms include insomnia).  Might be worth a blood test to see if its possible.  I know they say the deficiency is something developed at an older age, but I wonder what causes sleep problems in the young.

[Julie Walsh]

well, hindsight's 20/20. i thought i was just lucky that he napped so well, but even as a baby (before the sleep events started) he'd have have incredibly long naps, and had to be weaned from napping to attend school. For your grandson: check in to some sleep sites (there's one called 'children's sleep forum'@  http://www.sleepnet.com/child/child.html.  Forum #3 is current) that can discuss different sleep disorders and the difficulties surrounding these events for children. If there's any concern, I'd suggest keeping a sleep log to see how much rest he gets, perhaps video-taping him to see if he has arousal events, or for behaviour problems/daytime tiredness/other syptoms speak to the pediatrician who may order a sleep assessment.  I wasn't concerned until I linked his behaviour problems with how rested he seems to be, and then realized that how much rest he got had nothing to do with how long he was actually asleep.  Hoping for some direction from the doctors; I want to know what to ask, and what else I should be looking at, noticing, whatever.

[mlb]

My grandson is not even 2 and he has been giggling and laughing and talking to ???? for quite some time now.  We have hours (one session only!) of it on tape.  During the day, he becomes exhausted after only a few hours and then wants to go to bed (otherwise, he falls apart and will start hitting his head on the floor).  

Is this a symptom of something?  His father is an adult sleepwalker, and both his parents talked in their sleep alot as children and occasionally do now, as well.  

When did you notice symptoms in your 6 year old?

[CCF-Neuro-M.D.-JT]

I can understand your concern, especially since his symptoms are affecting his schoolwork and self-esteem. Video EEG monitoring refers to continuous minute to minute monitoring of the brain wave activity as well as video recording of the patient's activities. Patients are kept overnight for at least one day and then as long as needed for data gathering. Tell the neuro about the triggers such as temperature, which we sometimes use to stimulate the events in question if the patient doesn't have one on their own. Also, if the exam and/or EEG are showing abnormalities, imaging studies such as an MRI may be helpful. FInally, the best thing that you can do for your son right now is to be supportive. Reinforce all of his positive traits and let him know that he is not any of those things that he's saying. Best of luck.