Stridor as initial presentation of rolandic epilepsy.

Area of Science:

• Pediatric Otolaryngology
• Pediatric Neurology

Background:

• Laryngomalacia is a common congenital condition causing upper airway obstruction in infants.
• Adenotonsillectomy is a frequent surgical intervention for related symptoms, but may not resolve all airway issues.

Observation:

• A 5-year-old girl presented with worsening nocturnal stridor, ocular retroversion, and suspected apnea.
• Previous adenotonsillectomy did not resolve her respiratory symptoms.

Findings:

• Nasal fiberoptic endoscopy confirmed laryngomalacia as the cause of stridor.
• CO2 laser ariepiglotoplasty significantly improved the patient's airway symptoms.
• Post-operative follow-up revealed self-limited clonic facial movements during sleep onset.
• Electroencephalogram (EEG) findings were consistent with benign childhood epileptiform discharges.

Implications:

• Surgical intervention for laryngomalacia can be effective in improving airway obstruction.
• The co-occurrence of laryngomalacia and benign childhood epileptiform discharges warrants further investigation.
• This case highlights the importance of comprehensive evaluation in pediatric airway disorders.