Diagnosing an 11 Year Old Girl with Narcolepsy in a Child Psychiatry Unit: A Case Presentation (original) (raw)
2019, Journal of Dr Behcet Uz Children s Hospital
Narcolepsy is a chronic disorder that might cause severe morbidity and functional deterioration with a wide range of complicated symptoms and without any clearly identified etiology. The condition is even more difficult to diagnose in children as clinical picture and clusters of symptoms that vary extremely. With this report, we aimed to present, and discuss an 11-year-old case diagnosed with narcolepsy in a child psychiatry unit along with relevant literature. Psychiatric assessment of the case that applied to our child psychiatry unit was carried out by using Diagnostic and Statistical Manual of Mental Disorders 5 th edition (DSM-5) criteria. Detailed clinical examination, neurological tests and imaging modalities as well as polysomnography were performed. The case was diagnosed,and followed up as having narcolepsy after completion of processes of evaluation, and differential diagnosis. She demonstrated clinical improvement with a combined treatment regimen of methylphenydate-OROS and behavioral therapy for sleep pattern and hygiene. She is still being followed up in our unit. Since narcolepsy is a rarely seen condition encountered in child psychiatry settings and symptoms might mimic other neurological and psychiatric conditions, its earlier recognition is a remote possibility. Therefore, we believe that we, as child psychiatrists, need to bear this disorder in our minds for differential diagnosis. Since current treatment options mainly target visible symptoms, developing novel treatment strategies directed towards underlying etiology will carry importance. In that sense, we believe that increasing the number of case studies and clinical researches in this understudied field of child psychiatry shall contribute greatly to more improved understanding of the disorder.
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