warfarin and Sleep-Apnea-Syndromes

The usual differential diagnoses of nocturnal events in children include parasomnias, nocturnal seizures, nocturnal reflux (Sandifer syndrome), hypnic jerks, periodic limb movements of sleep, and sleep disordered breathing. We report a previously healthy young girl who presented to the sleep clinic for evaluation of nocturnal events which were diagnosed as medically refractory nocturnal seizures. It was not until a syncopal event occurred in the daytime, which prompted referral for cardiac evaluation, the diagnosis of idiopathic pulmonary arterial hyper-tension (IPAH) was made. Sleep physicians should consider IPAH in the differential diagnosis of nocturnal events in children.

Topics: Carbolines; Cardiac Output, Low; Child, Preschool; Diagnosis, Differential; Drug Therapy, Combination; Epoprostenol; Female; Humans; Hypertension, Pulmonary; Oxygen Inhalation Therapy; Parasomnias; Seizures; Severity of Illness Index; Sleep Apnea Syndromes; Tadalafil; Treatment Outcome; Warfarin

Topics: Adrenal Cortex Hormones; Adult; Anemia, Hemolytic, Autoimmune; Biopsy, Needle; Diagnosis, Differential; Follow-Up Studies; Giant Cell Arteritis; Glomerulosclerosis, Focal Segmental; Headache; Humans; Intracranial Hypertension; Male; Migraine Disorders; Sleep Apnea Syndromes; Vision Disorders; Warfarin