Pediatric Periodic Limb Movement Disorder: A Case Study
Learn how to assess patients with pediatric periodic limb movement disorder
We've previously written about periodic limb movements in sleep (PLMS) and restless legs syndome (RLS), but periodic limb movement disorder is not to be confused with RLS. Unlike RLS, PLMD occurs when you're asleep. Most other movement disorders manifes during periods of wakefulness. The condition is characterized as being remarkably periodic and the movements may cause poor sleep and subsequent daytime sleepiness.
PLMD may occur in conjunction with other sleep disorders and is related to, but not synonymous with, RLS, a less specific condition with sensory features that manifest during wakefulness. The majority of patients with RLS also have PLMD, but the reverse is not true. According to the AASM, treatment usually involves either dopaminergic medication in an attempt to modify activity of the subcortical motor system or, more commonly, sedative medications to allow uninterrupted sleep.
A study published in 2011 by The Journal of Clinical Sleep Medicine, investigated the "prevalence, sleep-related correlates, and polysomnographic correlates of PLMD in a large pediatric case series, and how it compares to pediatric obstructive sleep apnea (OSA)."
The study had a fascinating conclusion, in which researchers found that PLMD has "important clinical and polysomnographic correlates. In addition, PLMD has many characteristics that are different from pediatric OSA, suggesting that PLMD is a distinct pediatric sleep disorder, of which clinicians should be aware."
In the AAST's Case of the Month on a pediatric patient with limb movements, Dr. Richard Rosenberg describes a case involving a young patient who has multiple sleep disorders one of which include pediatric limb movement disorder.
This Case of the Month reviews standard recording techniques for children including end-tidal CO2 measurement, as well as the scoring of pediatric sleep studies. Diagnostic criteria for pediatric restless legs syndrome are also discussed, as well as comorbidities, effects of psychotropic medication and treatment alternatives.
The best part? This online lecture awards 1 CEC to sleep technologists and is available to AAST members at a discounted price.
Want to learn more about assessing and treating pediatric patients in the sleep lab? Learn more about risk management practices you can use to make your sleep center safe for patients of all ages.