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Introduction: A female adolescent patient with gradual hypersomnolence. Report of case(s) The patient is a 16-year-old with gradual onset of parasomnias, leg cramps, headaches and history of gastroesophageal reflux, and asthma. Her ferritin was low, and a diagnosis of restless legs was made, the patient was started on oral iron supplements without improvement. Intravenous iron replacement therapy was tried with laboratory improvement (>50 ng/ml) but not clinical. Clonazepam and gabapentin were tried without success. Over time, she developed more tiredness and started to fall asleep in class. A sleep study was done which showed primary snoring without evidence of sleep disorder breathing, PLMD index was 4.4, and REM sleep latency was 120 minutes. The headaches got worse, and she was seen by neurology, MRI showed a hyperintense 6mm rounded lesion on the left side of the thalamus. She start...