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[Periodic movements of the limbs during sleep in childhood]
M Bestué-Cardiel1, F Sanmartí, J Artigas
1Servicio de Neurología; Hospital Universitario Miguel Servet, Zaragoza, 50009, España. mbestugc@meditex.es
Insights
Periodic limb movements (PLM) in sleep are rare in children but can cause significant learning and behavioral issues. Early diagnosis is crucial for affected children to prevent long-term problems.
Area of Science:
- Neurology
- Sleep Medicine
- Pediatrics
Background:
- Periodic limb movements (PLM) in sleep are intrinsic dyssomnias causing insomnia and daytime somnolence.
- PLM affects 11% of the population, typically over 50, and is rare in children.
- While often linked to restless legs syndrome, PLM can occur independently.
Observation:
- This study presents two cases of PLM in girls under seven years old.
- Both cases exhibited severe neuropsychological disorders, including behavioral and feeding issues, and psychotic episodes.
- School performance was significantly impacted, leading to complete failure in one child.
Findings:
- PLM in childhood is uncommon but associated with significant neuropsychological comorbidities.
- The clinical course of PLM in children demonstrates variability, posing diagnostic and therapeutic challenges.
- Early identification of PLM in children is essential.
Implications:
- Pediatricians and sleep specialists should consider PLM in children presenting with sleep disturbances.
- Prompt diagnosis and management of PLM can mitigate severe behavioral and learning difficulties.
- Further research is needed to understand the long-term impact and optimal treatment strategies for pediatric PLM.
Introduction:
Periodic movements of the limbs (PML) whilst sleeping is a disorder included in the group of intrinsic dysomnias which cause problems of insomnia and somnolence during the day. It is usually associated with the restless legs syndrome (it occurs in 80% of the patients with this syndrome) although PML may occasionally be an isolated finding. The prevalence of the disease is of 11%. It usually occurs in patients aged over 50 years, and the frequency increase with age. It is uncommon in persons aged under 30 years. In children it is almost unknown. When it does occur in this age group it is usually associated with the restless legs syndrome.
Objective:
To obtain data regarding this disorder in childhood, in view of the scarcity of information available in the literature and the importance of the neuropsychological problems and difficulty with learning that affected children have.
Clinical Cases:
We report two cases of PML occurring in girls of under 7 years of age. They had severe associated neuropsychological disorders (disorders of behavior and feeding, psychotic episodes, etc.). The effect on performance at school led to complete failure in one case. We describe the clinical course of the two girls, emphasizing the variability, and both diagnostic and therapeutic difficulties.
Conclusions:
Although this condition is uncommon in childhood, it should always be borne in mind in cases of children with sleep disorders, since early diagnosis will prevent major behavior and learning problems.