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This chapter briefly reviews the use of structural and functional neuroimaging in the assessment and management of parasomnias. The majority of the work in the area of neuroimaging and parasomnias and sleep-related movement disorders has been in the area of RLS and PLMD. The scope of the work performed to date has been driven by, and constrained by, clinical manifestations of the disorder and by the measurements currently available by using neuroimaging tools. The most extensive work has been performed in the area of central dopaminergic dysfunction in these disorders. Neuroimaging methods allow determination of brain volumetric changes in patient samples to see if structural cerebral abnormalities may play a role in the disorder. Low-dose opioid treatment has been used in the management of some RLS patients, and nuclear medicine study reveals regional brain function associated with sleepwalking.
By
Roberta Leu, Department of Pediatrics, Case University School of Medicine, USA,
Carol L. Rosen, Department of Pediatrics, Case University School of Medicine, USA
This chapter helps clinicians to understand developmental changes in sleep patterns, screen for and identify common pediatric sleep disorders, know what tests and treatments to consider, and decide when to refer to a specialist. It describes the clinical presentation, basic evaluation, and management strategies for the most common sleep disorders in children in the following categories: insomnia, sleep-disordered breathing, hypersomnias, circadian rhythm sleep disorders, parasomnias, and sleep-related movement disorders. Obstructive sleep apnea (OSA) is a common health problem, affecting 2% of children. Onset of narcolepsy typically occurs between 15 and 25 years of age with a prevalence rate of 2 per 1000. Multiple physiologic processes of our bodies, including our sleep/wake cycle, follow circadian rhythms with a periodicity of roughly 24 hours. Sleep-related movement disorders involve restless legs syndrome (RLS) and rhythmic movement disorder (RMD).