Sleep Disruption and Proprioceptive Delirium due to Acetaminophen in a Pediatric Patient

Area of Science:

• Pediatric Neurology
• Pharmacology
• Toxicology

Background:

• Acetaminophen (paracetamol) is a widely used antipyretic and analgesic medication.
• Adverse effects are typically mild, but neurological disturbances are rarely reported.
• Understanding rare adverse reactions is crucial for patient safety.

Purpose of the Study:

• To report a case of sleep disruption and proprioceptive delirium associated with acetaminophen use in a child.
• To investigate the potential causal link between acetaminophen and the observed adverse neurological symptoms.
• To explore possible underlying mechanisms for these rare side effects.

Main Methods:

• Case report of a 7-year-old boy treated with acetaminophen for hyperpyrexia.
• Detailed documentation of symptoms, dosage, and timing of acetaminophen administration.
• Exclusion of alternative explanations and assessment of causality using the Naranjo algorithm.

Main Results:

• The patient experienced sleep disruption and proprioceptive delirium after acetaminophen administration.
• Symptoms resolved within one hour and recurred upon subsequent acetaminophen exposure.
• The Naranjo algorithm indicated a "probable" adverse drug reaction to acetaminophen.

Conclusions:

• Acetaminophen can be associated with rare neurological adverse effects such as sleep disturbances and delirium in children.
• Potential mechanisms may involve prostaglandin, dopamine, cannabinoid, or serotonin signaling pathways.
• Clinicians should be aware of these potential side effects when prescribing acetaminophen, especially in pediatric patients.