Vol. 30-31/2021-2022 Nr 60
okładka czasopisma Child Neurology
powiększenie okładki
Journal Info

CHILD NEUROLOGY

Journal of the Polish Society of Child Neurologists

PL ISSN 1230-3690
e-ISSN 2451-1897
DOI 10.20966
Semiannual


Powrót

Somnambulizm u dzieci


Somnambulism in children




Katedra i Klinika Neurologii Wieku Rozwojowego Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu

Neurol Dziec 2011; 20, 40: 69-78
Full text PDF Somnambulizm u dzieci



STRESZCZENIE
Somnambulizm (sennowłóctwo, lunatyzm, ang. sleepwalking) należy do parasomnii i polega na występowaniu złożonych zachowań podczas snu wolnofalowego (SWS), których skutkiem jest chodzenie podczas snu ze zmiennym stanem świadomości i zaburzeniami oceny. Epizody somnambulizmu występują w pierwszej połowie nocy, podczas snu głębokiego (stadia 3 i 4 NREM, czasem w stadium 2). Somnambulizm jest częstszy wśród dzieci i w większości przypadków z wiekiem samoistnie ustępuje. Nie ustalono jednoznacznej przyczyny patofizjologicznego mechanizmu występowania somnambulizmu, chociaż najnowsze dane sugerują dziedziczenie autosomalne dominujące o zmienne penetracji. W rozpoznaniu somnambulizmu spełnione muszę być następujące kryteria: A) chodzenie podczas snu; B) w trakcie trwania snu zmienny stan świadomości lub zaburzenia oceny w trakcie chodu są demonstrowane przez co najmniej jedną z następujących cech: 1) problemy z wybudzaniem pacjenta podczas epizodu; 2) splątanie po wybudzeniu z epizodu; 3) amnezja (całkowita lub częściowa) epizodu; 4) rutynowe zachowania pojawiające się o niewłaściwym czasie; 5) niewłaściwe lub bezsensowne zachowania; 6) niebezpieczne lub potencjalnie niebezpieczne zachowania; C) zaburzenie nie jest dostatecznie wyjaśnione przez inne zaburzenia snu, choroby, zaburzenia psychiczne, używane leki lub substancje. Istnieje spora grupa czynników nasilających epizody somnambulizmu, spośród których najczęściej wymieniany jest lek zolpidem. Epizody somnambulizmu powinny być różnicowane z nocnymi napadami padaczkowymi z płata czołowego, z innymi parasomniami oraz z nocnymi napadami panicznego lęku. Dotychczas nie powstały żadne rekomendacje lub algorytmy, które wskazywałby, jak należy leczyć pacjentów z epizodami somnambulizmu, chociaż przy bardziej nasilonych objawach najczęściej zalecanymi lekami są benzodiazepiny.

Słowa kluczowe: somnambulizm, nocne napady padaczkowe z płata czołowego, parasomnie u dzieci


ABSTRACT
Somnambulism (or sleepwalking) is an arousal parasomnia and consists of series of complex behaviors that are initiated during slow-wave sleep and result in walking during sleep. Episodes occur in the first half of the night during NREM sleep (stages 3 and 4, occasionally stage 2). Somnambulism is more common in children than in adults and resolves spontaneously with age. There has not been set a clear pathophysiological mechanism for the causes of occurrence of sleepwalking, although recent data suggest autosomal dominant inheritance with variable penetration. Diagnostic criteria of somnambulism are: A) ambulation occurs during sleep; B) sleepwalking is demonstrated by at least one of the following: 1. difficulty in arousing the patient during an episode,:2. mental confusion when awakened from an episode, 3. amnesia (complete or partial) for the episode, 4. routine behaviors that occur at inappropriate times, 5. inappropriate or nonsensical behaviors, 6. dangerous or potentially dangerous behaviors; C) the sleepwalking is not better explained by another reason. There is a large group of factors increasing episodes of sleepwalking, among which, the most frequently mentioned drug is zolpidem. Episodes of somnambulism should be differentiated from nocturnal frontal lobe epilepsy, other parasomnias and nocturnal panic attacks. So far there were no recommendations or algorithms indicating to the treatment of patients with episodes of somnambulism, although when the symptoms are more severe the most frequently prescribed drugs are benzodiazepines.

Key words: somnambulism, sleepwalking, frontal lobe epilepsy, parasomnias in children


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