Diagnostic pitfalls in children with sleep disorders: two cases with hypersomnia

Sleep disorders are common in children, yet several clinical pitfalls give rise to the unrecognition or improper management of those children. Here, we present diagnostic difficulties in two adolescents with narcolepsy and Kleine-Levin syndrome. The first patient was a 12-year-old girl who had been given Na-valproate for nearly a year because hypersomnia was initially perceived as unconsciousness periods of epileptic spells, and later attributed to the antiepileptic drug. The other patient was a 14-year-old boy who had been managed as a specific psychiatric disorder for several months despite the characteristic symptoms of Kleine-Levin syndrome (hypersomnia, hyperphagia, hypersexuality, behavioural and cognitive dysfunction). Both cases emphasize that sleep disorders could be manifested with various clinics and that there are several diagnostic challenges in children.

Sleep medicine needs to be given larger role in both training curriculum and post-graduate education for paediatricians.