Case history
Case history #1
A 4-year-old girl presents following episodes of awakening from sleep with very loud screaming, inconsolability, and agitation. The episodes are occurring 2 to 4 times per week, usually before 3 a.m., and lasting <20 minutes. According to her parents, she is very anxious during these episodes and sometimes short of breath. It is very difficult to communicate with her or to console her. She does not usually recall any of these events the following morning. On one occasion, the neighbours alerted the police after they heard her screaming and suspected child abuse. Her general and neurological examination is completely normal. Birth history is of a normal delivery with no postnatal infections. Her developmental history is normal, and her language skills are as expected for her age.
Case history #2
A 5-year-old boy frequently wakes up with screaming spells between 4 a.m. and 5 a.m. When his parents arrive at the bedside, he quickly hugs his mother and vividly describes that a blue furry monster is hiding under his bed. During the episodes he appears frightened but not agitated or uncomfortable. Within a few seconds he is orientated and within a few minutes goes back to sleep. His examination is normal.
Other presentations
Additional parasomnias may involve a child who sleepwalks out of the home, to be found by a neighbour or the police and brought back home. Some children will fall asleep in one location, such as their bed in their bedroom, and awaken in a completely different location, without recollection of moving out of bed.
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