Case 33 - A child with behavioral problems and violent sleep behavior leading to trauma

Summary

This chapter presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on a girl with a history of attention deficit hyperactivity disorder (ADHD). She was admitted to address significant behavioral problems that included prolonged rocking behaviors that often disrupted the patient's sleep. Vital signs were unremarkable, and developmentally she was Tanner stage 1, with a weight of 27.4 kg and a height of 130.5 cm. An MRI of the brain was performed to rule out neurological injury given the tight heel cords, brisk muscle stretch reflexes and right foot weakness. The patient's history and polysomnography (PSG) analysis are classical for rhythmic movement disorder (RMD); classified in ICSD-2 as a sleep-related movement disorder. To address the patient's mild gross motor delay, there was a recommendation for continued opportunities to engage in a variety of gross motor activities, with caution regarding those requiring balance/bilateral coordination.