A 4-yrs-old boy is brought to the physician by his parents for episodes of waking in the middle of the night screaming. The parents state that when they get to the boy’s room during one of these episodes, they find him in his bed, thrashing wildly, his eyes wide open. He pushes them away when they try to comfort him. After 2 min, the boy suddenly falls asleep, and the next day he has no memory of the episode. Which of the following medication is used to treat this disorder?
A. Haloperidol
B. Diazepam
C. Methylphenidate
D. Amitriptyline
The
Answer is.
(B). Diazepam
The
child in the question is experiencing episodes of sleep terror disorder, a
dyssomnia characterized by sudden partial arousal accompanied by piercing
screams, motor agita tion, disorientation, and autonomic arousal. The episodes
take place during the transition from deep sleep to REM sleep. Children do not
report nightmares (which would be associated with REM sleep) and do not have
any memory of the episodes the next day Sleep terrors occur in 3% of children
and 1% of adults. Although specific treatment for this disorder is seldom
required, in rare cases it is necessary. Diazepam (Valium) in small doses at
bedtime improves the condition and sometimes completely eliminates the attacks.
