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本文报告1例6岁女童首次发生发作性睡病被误诊为不典型癫痫。之后10个月在8家不同医院被误诊为其他疾病,最后才得以确诊。发作性睡病的诊断在小儿中比较困难,因为睡眠发作、猝倒、入睡前幻觉和睡眠麻痹四个主要症状都存在的病例在儿童中极少见到。患儿往往发作期更长、症状多样化。为了缩短从首次发病到确诊的时间,我们建议对所有不明原因过度睡眠的患儿监测睡眠并进行睡眠潜伏期试验,以排除发作性睡病的可能,而不论其相关症状如何。该病例凸显出罕见精神障碍的表现可以是多种多样的,特别是儿童。这就需要临床医生在采集病史时要充分考虑这些病例的非典型表现。
This article reports the first occurrence of narcolepsy in a 6-year-old girl who was misdiagnosed as atypical epilepsy. After 10 months in 8 different hospitals were misdiagnosed as other diseases, finally confirmed. The diagnosis of narcolepsy is more difficult in children because the four major symptoms of sleep deprivation, cataplexy, pre-sleep hallucinations and sleep paralysis are rare in children. Children often have longer episodes and more diverse symptoms. In order to shorten the time from the first onset to the diagnosis, we recommend monitoring sleep and sleep latency in all children with unexplained over-sleep to rule out the possibility of narcolepsy, regardless of the relevant symptoms. The case highlights the manifestations of rare mental disorders that can be varied, especially in children. This requires clinicians to take full account of the atypical findings of these cases when collecting their medical history.