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Obstructive sleep apnea syndrome as a rare presentation in a young girl with a central nervous system tumor

Fern Buller1, Muhammad A Kamal2, Samantha K Brown1

  • 1Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, UK.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|December 6, 2021
PubMed

Insights

Obstructive sleep apnea syndrome (OSAS) in children can rarely be caused by brain tumors. Prompt neurological evaluation is crucial for diagnosing OSAS in children without typical risk factors like enlarged tonsils.

Area of Science:

  • Pediatric Sleep Medicine
  • Pediatric Neurology
  • Otolaryngology

Background:

  • Sleep-related breathing disorders are prevalent in children, with obstructive sleep apnea syndrome (OSAS) being the most common.
  • OSAS in children is typically linked to airway obstruction, such as tonsillar hypertrophy or obesity.
  • In adults, OSAS can stem from central nervous system (CNS) issues, like brain tumors, but this is rare in pediatric cases.

Observation:

  • A 2-year-old girl presented with severe OSAS symptoms including snoring, restless sleep, and apneic events.
  • She had no comorbidities, and her tonsils were normal-sized.
  • A sleep study confirmed severe OSAS with an apnea/hypopnea index of 34.

Findings:

  • A CNS tumor was identified as the underlying cause of OSAS in this child.
  • Surgical excision of the tumor led to the complete resolution of her OSAS.
  • This case demonstrates a rare presentation of OSAS in a pediatric patient.

Implications:

  • Highlights the importance of a thorough neurological examination in the evaluation of pediatric OSAS, especially when typical risk factors are absent.
  • Suggests considering CNS pathology in the differential diagnosis of pediatric OSAS.
  • Underscores the potential for neurological conditions to manifest as sleep-disordered breathing in children.

Keywords:
brain tumorobstructive sleep apnea syndromesleep-disordered breathing

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