The case report of a child with the diagnosis of a pineal tumor and severe, chronic sleep disorder is reported. Due to treatment of her lesion, the nighttime melatonin secretion was markedly suppressed. For 41/2 years, she has been receiving oral melatonin, which has greatly improved her sleep, without any adverse effects. Sleep difficulties should be considered in the management of pineal lesions. Melatonin replacement therapy is beneficial for those patients who have deficient melatonin synthesis. (J Child Neurol 2001;16:139-140).
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