Home Initiation of Nocturnal Non-Invasive Ventilation in Two Adolescents with Duchenne Muscular Dystrophy and comorbid Autism Spectrum Disorder and ADHD

Pien Weerkamp ^1,2* Mark Voermans ³ Moniek Finders ³ Arno Brouwers ³ Philippe Collin ^1,4 Sylvia Klinkenberg ^1,5 Jos Hendriksen ^1,3

• ¹ Academic Centre for Epileptology, Epilepsy Center Kempenhaeghe, Heeze, Netherlands
• ² Maastricht University, Maastricht, Netherlands
• ³ Maastricht University Medical Centre, Maastricht, Limburg, Netherlands
• ⁴ koraal groep, sittard, Netherlands
• ⁵ University College Maastricht (UCM), Maastricht, Netherlands, Netherlands

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.