0812 Periodic Limb Movements in the Setting of Pediatric Traumatic Brain Injury

Abstract Introduction Sleep disturbances following traumatic brain injury (TBI) are commonly diagnosed and can affect up to 70% of individuals, with many occurring after mild injuries such as concussions.1 Patients experience a variety sleep problems sleep-wake disturbances, infrequent parasomnias, periodic limb movement disorders. While movements (PLMs) occur in pediatric patients, they rare compared their adult counterparts. Literature is limited regarding the presence PLMs post-concussion population. We describe an unusual case setting TBI patient. Report Cases: A 6-year-old male past medical history significant for adeno-tonsillar hypertrophy chronic cough was brought emergency department by ambulance being found facedown secondary fall at school. Physical examination findings were dried blood nares abrasion anterior nasal bridge. No other signs trauma noted, his Glasgow Coma Scale (GCS) 15. Computerized Tomography (CT) scan head negative any acute intracranial abnormality. He sent home concussion precautions. Prior concussion, age 4, he obstructive apnea (OSA) via polysomnography (PSG). Moderate OSA noted hypopnea index (AHI) 8.1 per hour leading adenotonsillectomy. Five weeks evaluation pediatrician revealed complaints restless worsened emotional lability prompting referral clinic. By comparison, patient’s post-TBI PSG 6 showed no evidence sleep-disordered breathing (AHI 1.48 hour) but new elevated PLM 6.56 hour. An iron panel pending. Conclusion rarely entity and, our knowledge, has never been reported literature. Our suggests that clinicians should have high level suspicion consider assess which recovery overall quality-of-life Support (If Any) Viola-Saltzman M, Watson NF. Traumatic Neurol Clin. 2012;30(4):1299-1312. doi:10.1016/j.ncl.2012.08.008