A Child Who Flickers Her Fingers while Falling Asleep

摘要

A 5-year-old girl presented to a pediatric sleep laboratory for polysomnography to address the referring physician's suspicion for obstructive sleep apnea. During the sleep study, the technician noticed that the child stared for 10 to 15 seconds, became unresponsive, and flickered the fingers of her left hand as she fell asleep (Video 1). This behavior had also been observed by the child's mother, who believed it to be part of a habitual self-soothing behavior. There was no recall of similar events during the day and no report of tongue biting or bladder or bowel incontinence, but occasional brief episodes of staring had been observed. There was no significant medical history. Her body mass index was 17.29 kg /m2. Examination revealed a Mallampati score of 2 and a tonsil size of 2+. The remainder of the physical examination was normal.