Case Report

New Onset Insomnia in a Pediatric Patient: A Case of Anti-NMDA Receptor Encephalitis

Table 1

Differential diagnosis for insomnia in children.

Behavioral insomnia of childhood [8]
(i) Inconsistent bedtime routine
(ii) Inadequate limit setting
(iii) Use of electronic device
(iv) Parental discord
(v) Emotional, physical, and sexual abuse
Primary sleep disorders [8, 9]
(i) Obstructive sleep apnea
(ii) Circadian rhythm sleep wake disorders
(iii) Parasomnias
(iv) Restless leg syndrome
(v) Periodic limb movements of sleep
(vi) Bruxism
Medical conditions [914]
(i) Allergic rhinitis, atopic dermatitis, otitis media, asthma, chronic cough, and cystic fibrosis
(ii) Colic, gastroesophageal reflux, inflammatory bowel disease, and irritable bowel syndrome
(iii) Malignancy and sickle cell anemia
(iv) Congenital heart disease and cardiac arrhythmias
(v) Juvenile idiopathic arthritis, systemic lupus erythematosus, diabetes, and thyroid disease
(vi) Chronic pain and fibromyalgia
Acquired central nervous system disorders [7, 1519]
(i) Concussion and postconcussive syndrome
(ii) Traumatic brain injury
(iii) Viral, bacterial, or autoimmune meningoencephalitis
(iv) Increased intracranial pressure
(v) Stroke
Neurologic disorders [9, 11, 2023]
(i) Neurodegenerative disease and static encephalopathy
(ii) Autism spectrum disorder
(iii) Cerebral palsy
(iv) Intellectual disability
(v) Visual and/or hearing impairment
(vi) Migraine headaches, tension headaches, and chronic daily headache
(vii) Idiopathic intracranial hypertension
(viii) Epilepsy
(ix) Multiple sclerosis and acute disseminated encephalomyelitis
(x) Myasthenia gravis
Psychiatric disorders [8, 9, 11, 24]
(i) Major depressive disorder
(ii) Anxiety disorders
(iii) Posttraumatic stress disorders
(iv) Attention deficit hyperactivity disorder
(v) Bipolar affective disorder
(vi) Schizophrenia
(vii) Psychosis
Medication-induced insomnia [25]
(i) Acute intoxication
(ii) Alcohol, tobacco, or illicit drug use
(iii) Caffeine
(iv) Diet pills
(v) Antibiotics
(vi) Antidepressants
(vii) Antipsychotics
(viii) Alpha 2 agonists
(ix) Beta antagonists
(x) Beta agonists
(xi) Glucocorticoids
(xii) Antihistamines
(xiii) Decongestants