III
Pavor nocturnus is a malady peculiar to children from the third to the seventh year, and must not be confounded with nightmare.
The symptoms are the following: Sudden awaking of the child after a few hours of profound sleep.—A vivid expression of great terror, the eyes fixed on some point, as though on some apparition standing before them.—Failure of consciousness: the child recognises no one, and does not reply to questions.—Skin bathed in perspiration.—Stronger cardiac pulsations.—Rapid pulse.—Laboured breath.—Trembling of the limbs.—Temperature normal.
The intensity, duration, and frequency of these attacks vary greatly; they last generally from five to twenty minutes, after which the children recover consciousness and fall asleep.
In the morning they remember nothing. Rarely do the attacks occur several times in the same night; they appear as a rule at intervals of a few days, often disappearing altogether after occurring two or three times.
The causes of this malady are hereditary or accidental. Pale, delicate, thin, scrofulous, anæmic, very intelligent or irritable children are easily attacked; predisposed to it also are children of excitable parents, or of those troubled with nervous affections. Amongst occasional causes of the pavor nocturnus may be specially mentioned strong emotions, fever, and diseases of the digestive organs. In general the children recover; the prognosis, as we say, is favourable.
Some retain their excessive nervous excitability, are subject to palpitation of the heart, but only in very exceptional conditions have the attacks of pavor nocturnus exercised a lastingly injurious influence.