Uyurgezerliğin Eşlik Ettiği Obsesif Kompulsif Bozukluk Olgusunda Fluoksetin Tedavisi ile Düzelen Uyurgezerlik
Abstract
Uyurgezerlik uyku sırasında yataktan kalkma ve gezinme dönemleri ile karakterize bir uyku bozukluğu olup genel toplum yaygınlığı %1-5 arasında bildirilmektedir. Uyurgezerliğin tam olarak patofizyolojik mekanizması bilinmemektedir. Ancak ateş gibi fizyolojik sorunlar, emosyonel stres (çocukta ayrılık anksiyetesi gibi), altta yatan medikal sebepler (obstrüktif uyku apnesi, hipertiroidi, migren, inme, ensefalitler), santral sinir sistemini etkileyen ilaç-maddeler (alkol, sedatif-hipnotikler, antikolinerjikler, lityum gibi), dolu mesane, perimensturasyon gibi fizyolojik iç uyaranlar ve ışık-ses gibi dış uyaranların uyurgezerlik için eşiği düşürdüğü ve tetikleyici olabileceği söylenmektedir. Bu olgumuzda 1 yıldır uyurgezerlik öyküsü olan ve son 15 gündür atakların sıklığında ve şiddetinde ciddi artma olan 9 yaşında kız hasta üzerinden hastalığın patofizyolojisi, tetikleyicileri, tanısı ve tedavisinde izlenen yollara yönelik bilgiler sunulacaktır.
References
- Amerikan Psikiyatri Birliği (APA). Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı, 5. basım (DSM-5), Tanı Ölçütleri Başvuru Elkitabı. Köroğlu E (çev). Ankara: Hekimler Yayın Birliği, 2013a.
- Rosen GM. Disorders of arousal. In: Sheldon SH (ed). Principles and Practice of Pediatric Sleep Medicine, 2nd ed. London: Elsevier Saunders, 2014:313-20.
- Westchester IL. American Academy of Sleep Medicine. International Classification of Sleep Disorders. Diagnostic and Coding Manual. 2nd ed. American Academy of Sleep Medicine, 2005.
- Plazzi G, Vetrugno R, Provini F, Montagna P. Sleepwalking and other ambulatory behaviours during sleep. Neurol Sci 2005;26:S193-8.
- Klackenberg G. Somnambulism in childhood-prevalence, course and behavioral correlations. A prospective longitudinal study (6–16 years). Acta Paediatr Scand 1982;71:495–9.
- Sullivan S, Guilleminault C. Disorders of arousal from non-rEM sleep. Chockroverty S (ed). Sleep and Movement Disorders. 2nd ed. New York: Oxford University Press, 2013:396-405.
- Juszczak GR, Swiergiel AH. Serotonergic hypothesis of sleepwalking. Med Hypotheses 2005;64:28-32.
- Richerson GB, Wang W, Tiwari J, Bradley SR. Chemosensitivity of serotonergic neurons in the rostral ventral medulla. Respir Physiol 2001;129:175-89.
- Kawashima T, Yamada S. Paroxetine-induced somnambulism. J Clin Psychiatry 2003;64:483.
- Landry P, Warnes H, Nielsen T, Montplaisir J. Somnambulistic- like behaviour in patients attending a lithium clinic. Int Clin Psychopharmacol 1999;14:173–5.
- Gau SF, Soong WT. Psychiatric comorbidity of adolescents with sleep terrors or sleepwalking: A case-control study. Aust N Z J Psychiatry 1999;33:734-9.
- Dahl RE. The pharmacologic treatment of sleep disorders. Psychiatr Clin North Am 1992;15:161-78.
Sleepwalking Improved with Fluoxetine Treatment in a Case of Obsessive Compulsive Disorder Accompanied by Sleepwalking
Abstract
Sleepwalking is a sleep disorder characterized by periods of waking up and travelling around during sleep, and its prevalence in general population is reported to be 1-5%. The pathophysiological mechanism of sleepwalking is not fully understood. However it is said that physiological problems such as fever, emotional stress (like child’s separation anxiety), underlying medical reasons (like obstructive sleep apnea, hyperthyroidism, migraine, stroke, encephalitis), drugs and substances that affect the central nervous system (like alcohol, sedatives-hypnotics, anticholinergics, lithium), physiological internal stimuli such as full bladder, perimenstruation and external stimuli such as light-noise may decrease the threshold for sleepwalking and trigger it. Information will be provided about the pathophysiology, triggers, diagnosis and treatment of the disease through our case of a 9-year-old girl with a sleepwalking history of one year and a severe increase in the frequency and severity of episodes in the last 15 days
References
- Amerikan Psikiyatri Birliği (APA). Ruhsal Bozuklukların Tanısal ve Sayımsal Elkitabı, 5. basım (DSM-5), Tanı Ölçütleri Başvuru Elkitabı. Köroğlu E (çev). Ankara: Hekimler Yayın Birliği, 2013a.
- Rosen GM. Disorders of arousal. In: Sheldon SH (ed). Principles and Practice of Pediatric Sleep Medicine, 2nd ed. London: Elsevier Saunders, 2014:313-20.
- Westchester IL. American Academy of Sleep Medicine. International Classification of Sleep Disorders. Diagnostic and Coding Manual. 2nd ed. American Academy of Sleep Medicine, 2005.
- Plazzi G, Vetrugno R, Provini F, Montagna P. Sleepwalking and other ambulatory behaviours during sleep. Neurol Sci 2005;26:S193-8.
- Klackenberg G. Somnambulism in childhood-prevalence, course and behavioral correlations. A prospective longitudinal study (6–16 years). Acta Paediatr Scand 1982;71:495–9.
- Sullivan S, Guilleminault C. Disorders of arousal from non-rEM sleep. Chockroverty S (ed). Sleep and Movement Disorders. 2nd ed. New York: Oxford University Press, 2013:396-405.
- Juszczak GR, Swiergiel AH. Serotonergic hypothesis of sleepwalking. Med Hypotheses 2005;64:28-32.
- Richerson GB, Wang W, Tiwari J, Bradley SR. Chemosensitivity of serotonergic neurons in the rostral ventral medulla. Respir Physiol 2001;129:175-89.
- Kawashima T, Yamada S. Paroxetine-induced somnambulism. J Clin Psychiatry 2003;64:483.
- Landry P, Warnes H, Nielsen T, Montplaisir J. Somnambulistic- like behaviour in patients attending a lithium clinic. Int Clin Psychopharmacol 1999;14:173–5.
- Gau SF, Soong WT. Psychiatric comorbidity of adolescents with sleep terrors or sleepwalking: A case-control study. Aust N Z J Psychiatry 1999;33:734-9.
- Dahl RE. The pharmacologic treatment of sleep disorders. Psychiatr Clin North Am 1992;15:161-78.
Details
| Other ID | JA76NF26KR |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | August 1, 2018 |
| Submission Date | August 1, 2018 |
| Published in Issue | Year 2018 Volume: 12 Issue: 2 |
The publication language of Turkish Journal of Pediatric Disease is English.
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