Source:Sleep Medicine
Author(s): Orlane Felix, Alessandro Amaddeo, Jorge Olmo, Michel Zerah, Stephanie Puget, Valerie Cormier-Daire, Genevieve Baujat, Graziella Pinto, Marta Fernandez-Bolanos, Brigitte Fauroux
ObjectiveCentral sleep apnea (CSA) syndromes are rare in children and data in children over 1 year of age are scarce. The aim of the study was to describe the sleep characteristics, underlying disorders, management and outcome of children with CSA.Patients/MethodsA retrospective chart review of all children >1 year of age, diagnosed with CSA on a laboratory sleep study during a 20-month period, was performed. CSA was defined by a central apnea index (CAI) >5 events/h. The clinical management and the patient's outcome were analyzed.ResultsEighteen of 441 (4.1%) patients recorded during the study period had CSA. The median CAI, pulse oximetry, and oxygen desaturation index were 13/h (range 6–146), 96% (93–98%), and 18/h (6–98), respectively. Neurosurgical pathologies represented the most common underlying disorders with Arnold Chiari malformation in four and ganglioglioma in three patients. Other underlying disorders were Prader Willi syndrome (N=3), achondroplasia (N=2), Down syndrome with one patient having an achondroplasia and a Down syndrome. The remaining six patients had other genetic diseases. The most common investigation was brain magnetic resonance imaging. Individualized management with neurosurgery and/or chemotherapy, continuous positive airway pressure (in two patients having associated obstructive events) or noninvasive ventilation resulted in an improvement in CSA and the clinical presentation in 11 patients.ConclusionCSA is rare in children >1 year of age. Underlying disorders are dominated by neurosurgical disorders. Individualized management is able to improve CSA and the clinical condition in most patients.
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