Prolonged head banging improved by adenoidectomy in a 6-year-old girl

Abstract

Background

Head banging is a sleep-related rhythmic movement disorder in children, characterized by sudden banging of the head on the crib headboard or side railing during sleep. It usually improves before 4 years of age, but may persist into adolescence owing to specific etiologies.

Case report

We describe the case of a 6-year-old Japanese girl who had exhibited prolonged head banging since the age of 6 months. As polysomnography revealed obstructive sleep apnea at age 6, adenoidectomy was performed to resolve her sleep disturbances. The head banging decreased dramatically after the adenoidectomy and was associated with reduced periodic limb movements, and increased long sleep fragmentation.

Discussion

Head banging is a subtype of sleep-related rhythmic movement disorder, which mainly affects infants and children. Sleep apnea reportedly causes sleep-related rhythmic movement disorders in adults; however, there have been only one report in children with head banging. We demonstrated that prolonged head banging was dramatically reduced by adenoidectomy, suggesting that obstructive sleep apnea could exacerbate head banging during childhood.

Conclusion

Head banging in children over 5 years of age has diverse etiologies. Obstructive sleep apnea could be considered one of the few possible causes of prolonged head banging.