Sleep Disturbance and Rage Attacks in Opsoclonus-Myoclonus Syndrome: Response to Trazodone

• Published in: The Journal of pediatrics 2005-09, Vol.147 (3), p.372-378
• Main Authors: Pranzatelli, Michael R., Tate, Elizabeth D., Dukart, William S., Flint, Mary Jo, Hoffman, Michael T., Oksa, Amy E.
• Format: Article
• Language: English
• Subjects: Adolescent; Affective Symptoms - drug therapy; Affective Symptoms - etiology; Biological and medical sciences; Child; Child, Preschool; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Dose-Response Relationship, Drug; Female; General aspects; Humans; Infant; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Oculomotor disorders; Ophthalmology; Paraneoplastic Syndromes, Nervous System - psychology; Rage; Retrospective Studies; Serotonin Uptake Inhibitors - therapeutic use; Sleep Wake Disorders - drug therapy; Sleep Wake Disorders - etiology; Trazodone - administration & dosage; Trazodone - therapeutic use; Treatment Outcome
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2005.05.016

Parents of children with opsoclonus-myoclonus syndrome (OMS) frequently describe poor sleep and rage attacks. We hypothesized that these manifestations are related and could result from underlying monoaminergic dysfunction. We clinically characterized the sleep and behavioral characteristics of 51 young children with OMS; 19 of those with the most disruptive sleep patterns were treated with trazodone, a soporific serotonergic agent. Sleep disturbances, including prolonged sleep latency, fragmented sleep, reduced quantity of sleep, snoring, and nonrestorative sleep, were reported in 32 children, and frequent rage attacks were reported in 25. In 59% of the poor sleepers, parents felt that the problem was severe enough to warrant treatment. Children sleeping