最近审阅: 26 十月 2020
最近更新: 08 二月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 事件中认知紊乱(意识模糊性觉醒、睡惊症、睡行症)
  • 激烈活动或暴力行为(意识模糊性觉醒、睡行症、睡惊症和快速动眼睡眠行为障碍 [Rapid eye movement sleep behaviour disorder, RBD])
  • 多次出现无法活动的状态(复发性孤立性睡眠麻痹)
  • 事件中的自主神经过度兴奋(睡惊症)
  • 遗忘症
  • 发作期间常规的体格检查

其他诊断因素

  • 行为举止和面部表情异常(意识模糊性觉醒、睡行症、睡惊症)
  • 受伤证据

危险因素

  • NREM 异态睡眠障碍的家族史(意识模糊性觉醒、睡行症、睡惊症)
  • HLA 基因 DQB1*05 和 *04 等位基因的存在(睡行症)
  • 摄入精神类药物或酒精
  • 精神障碍病史
  • 发热
  • 急性睡眠剥夺或不规律的睡眠-觉醒节律障碍
  • 情绪应激和创伤性生活事件
  • 被迫觉醒
  • 未经治疗的合并睡眠障碍
  • 月经前状态(青春期女童)

诊断性检查

首要检查

  • 临床检查
  • 多导睡眠描记(快速动眼睡眠行为障碍)
更多 首要检查

需考虑的检查

  • 多导睡眠描记(意识模糊性觉醒)
  • 多导睡眠描记(睡行症)
  • 多导睡眠描记(睡惊症)
  • 多导睡眠描记(梦魇障碍)
  • 多导睡眠描记(其他异态睡眠障碍)
  • 利用扩展的 EEG 视频记录进行的多导睡眠描记
  • 尿液药物筛查
更多 需考虑的检查

治疗流程

撰稿人

Co-Director, Pediatric Sleep and Research Center

Cardinal Glennon Childrens Hospital

Associate Professor of Neurology

Saint Louis University School of Medicine

St Louis

MO

利益声明

RM declares that he has no competing interests.

Co-Medical Director, Sleep Medicine and Research Center

St. Luke's Hospital

Adjunct Associate Professor

Department of Pediatrics

Saint Louis University School of Medicine

St Louis

MO

利益声明

SP receives royalties from UpToDate for writing two topics: diagnosis and management of pediatric obstructive sleep apnea.

Dr Raman Malhotra and Dr Shalini Paruthi would like to gratefully acknowledge Dr Alon Y. Avidan, the previous contributor to this monograph. AYA has been paid honorarium speaking fees by the American Academy of Sleep Medicine, the American Academy of Neurology, the American College of Chest Physicians, Sepracor Inc, Cephalon Inc, and Pfizer Pharmaceuticals.

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Consultant in Paediatric Neurodisability

Evelina Children's Hospital

St Thomas' Hospital

London

UK

利益声明

PG is lead applicant on the ongoing MENDS trial, which is concerned with the use of melatonin in children with neurodevelopmental disorders and impaired sleep.

Reader in Psycho-Social Intervention

Centre for Evidence Based Intervention

Barnett House

University of Oxford

Oxford

UK

利益声明

PM has received funding greater than 6 figures USD from the Swedish Board of Health and Welfare, Martek Biosciences, Danish Social Research Institute, UK Department of Health, UK Health Technology Assessment Programme. PM declares that he has no competing interests.

Associate Professor of Pediatrics

Chief

Division of Pulmonary and Sleep Medicine

Department of Pediatrics

Medical College of Wisconsin

Medical Director

Pulmonary Clinic

Children's Hospital of Wisconsin

Milwaukee

WI

利益声明

LAD declares that she has no competing interests.

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