Case Report: Home initiation of nocturnal non-invasive ventilation in two adolescents with Duchenne muscular dystrophy and comorbid autism spectrum disorder and ADHD

病例报告:两名患有杜氏肌营养不良症并合并自闭症谱系障碍和注意力缺陷多动障碍的青少年在家中开始夜间无创通气治疗

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Abstract

This case report describes initiation of Nocturnal Non-Invasive Ventilation in home settings for two adolescents with Duchenne Muscular Dystrophy and different neuropsychiatric and neurocognitive comorbidities: one has Autism Spectrum Disorder, and the other has Attention Deficit Hyperactivity Disorder, obsessive thinking and anxiety. This report emphasizes the need for a multidisciplinary team approach, incorporating medical, psychological and psychopharmacological interventions for successful Non-Invasive Ventilation implementation. Challenges include recognition of neuropsychiatric and neurocognitive comorbidities often seen in Duchenne Muscular Dystrophy. Lessons learned from these cases underscore the importance of: coordinated multidisciplinary efforts, early advanced care planning, accurate psychoeducation, cautious psychopharmacological interventions, and parental and patient involvement. To our knowledge, this is the first case report describing implementing Nocturnal Non-Invasive Ventilation in home settings in adolescents with Duchenne Muscular Dystrophy and neuropsychiatric and neurocognitive comorbidities. In conclusion, implementation at home can be successful and become a realistic target for each individual with Duchenne Muscular dystrophy.

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