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Case Reports in Pediatrics
Volume 2013, Article ID 471294, 2 pages
Case Report

Sleep Disruption and Proprioceptive Delirium due to Acetaminophen in a Pediatric Patient

1Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, University Hospital “Luigi Sacco” Università di Milano, 20157 Milan, Italy
2Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Lecco, Italy
3Pharmaceutical Service, Azienda Sanitaria Locale di Bergamo, 24100 Bergamo, Italy
4Family Pediatricians, Territorial Health Service of Bergamo, 24100 Bergamo, Italy

Received 25 January 2013; Accepted 17 February 2013

Academic Editors: E. De Vries, I. J. Griffin, K. Kowal, and D. J. Licht

Copyright © 2013 Carla Carnovale et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We present the case of a 7-year-old boy, who received acetaminophen for the treatment of hyperpyrexia, due to an infection of the superior airways. 13 mg/kg (260 mg) of acetaminophen was administered orally before bedtime, and together with the expected antipyretic effect, the boy experienced sleep disruption and proprioceptive delirium. The symptoms disappeared within one hour. In the following six months, acetaminophen was administered again twice, and the reaction reappeared with similar features. Potential alternative explanations were excluded, and analysis with the Naranjo algorithm indicated a “probable” relationship between acetaminophen and this adverse reaction. We discuss the potential mechanisms involved, comprising imbalances in prostaglandin levels, alterations of dopamine, and cannabinoid and serotonin signalings.