Jay Gattis PsyD¹, Binh Pham DO MPH MS^1,

An 11-year-old child presented with caregiver-reported disturbances in recognition of familiar people and surroundings following overnight sleep and brief daytime naps, fluctuating access to previously acquired abilities, and recurrent episodes of prolonged unresponsiveness. Deterioration also occurred during intercurrent illnesses without preceding sleep. An initial electroencephalogram (EEG) showed no epileptiform discharges but did not capture stage N2 sleep; a subsequent overnight EEG was reportedly unremarkable. Later quantitative EEG (QEEG) evaluation described posterior temporal-occipital rhythmic activity with possible enhancement during drowsiness or light sleep. A separate neurological interpretation of EEG data documented background slowing for age, occipital intermittent rhythmic delta activity with embedded sharp or spike-like waveforms, and stage N2 sleep. However, no habitual clinical episode was captured electrographically, and a quantitative increase in abnormal activity during sleep was not demonstrated. Cerebral perfusion single-photon emission computed tomography (SPECT) identified qualitative regional differences in relative tracer distribution of uncertain clinical significance. Standardized longitudinal neuropsychological test results were unavailable, and the diagnostic evaluation remained incomplete. This case highlights the importance of distinguishing apparent memory loss from impaired retrieval or access to previously acquired information, obtaining appropriately documented sleep-inclusive neurological assessment, and interpreting ancillary findings without unsupported causal attribution.

sleep-associated amnesia, pediatric neurocognitive dysfunction, memory retrieval, electroencephalography, sleep-related neurological disorders, cerebral perfusion SPECT