Sleep terrors in a 14-year-old boy - a case report

INTRODUCTION: Sleep terrors occur in 1- 6.5% in children, typically between 4-12 years of age, with a peak between 5 -7 years of age. It is of unknown etiology and is self-limiting, in most cases. it is associated with N-REM sleep. CASE REPORT: A 14 years old boy, from urban background, brought to us for episodes of abnormal behavior occurring in the middle of the night during the preceding 10 days. Those episodes were of sudden onset, awakening from sleep begin with panicky scream, and are characterized by intense anxiety, sweating, crying, and increased heart rate. These episodes lasted for 15-20 minutes after which patient was back to sleep. The following day, the boy could recall most of the episode except for the initial 3-5 minutes. The boy had no significant psychological stressors. DISCUSSION: In view of the atypical age of onset and lack of memory for the initial few minutes of the episodes, a neurologic opinion was sought. EEG and MRI brain were undertaken and found within normal limits. We treated him with clonazepam 0.5 mg h.s. for two days with which the symptoms subsided. Review after a week revealed him to be asymptomatic. CONCLUSION: Clinical presentation of sleep terrors in this case occurred at a late age of 14 years, which is a rare presentation. The symptoms also raised a doubt of complex partial seizures, which were excluded by neurologic evaluation.