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Effects of adenotonsillectomy on neurocognitive function in pediatric obstructive sleep apnea syndrome

Fumie Horiuchi1, Yasunori Oka2, Kenjiro Komori3

  • 1Department of Neuropsychiatry and Neuroscience, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan.

Case Reports in Psychiatry
|June 28, 2014
PubMed

Insights

Obstructive sleep apnea syndrome (OSAS) in children can cause ADHD-like symptoms and enuresis. Treating OSAS with adenotonsillectomy significantly improved cognitive functions and behavioral issues in a pediatric patient.

Area of Science:

  • Pediatric Pulmonology
  • Pediatric Neurology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea syndrome (OSAS) in children presents with sleep disturbances and associated issues like growth failure, enuresis, learning difficulties, and ADHD-like symptoms.
  • Adenotonsillar hypertrophy is the most common cause of pediatric OSAS.

Purpose of the Study:

  • To evaluate neurocognitive functions and behavioral symptoms in a child with OSAS before and after adenotonsillectomy.
  • To highlight the link between pediatric OSAS, ADHD-like symptoms, and enuresis.

Main Methods:

  • A case study of an 11-year-old boy with suspected ADHD and nocturnal enuresis.
  • Diagnosis of OSAS confirmed by polysomnography.
  • Treatment involved adenotonsillectomy.

Main Results:

  • Post-surgery, the apnea/hypopnea index decreased significantly (21.9 to 1.8).
  • Enuresis frequency reduced from nightly to 2-3 times per month.
  • Neurocognitive assessment showed improved attention capacity, and behavioral problems, including ADHD-like symptoms, considerably ameliorated.

Conclusions:

  • Adenotonsillectomy effectively treated OSAS and improved associated neurocognitive and behavioral deficits in this pediatric patient.
  • Medical evaluation for children with suspected ADHD should include assessment for OSAS, particularly adenotonsillar hypertrophy.
  • Sleep evaluation is crucial for children presenting with ADHD-like symptoms.

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