Cases reported "self mutilation"

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1/411. A syndrome of psychosis following discontinuation of an estrogen-progestogen contraceptive and improvement following replacement: A case report.

    Mild forms of psychosis associated with low estrogen levels during the perimenopause are relatively frequent. There is scarce data on severe forms of psychosis in these conditions. We report the case of a 51-year-old woman with no previous psychiatric history who amputated her hand in a 'psychotiform' state after discontinuation of her contraceptive medication. Having subsequently jumped out of a window, she suffered a fracture of the dens with central spinal cord injury and symptoms of cruciate paralysis. The patient stabilized under a combined therapy with estrogen-progestogen substitution, antipsychotic medication and add-on oxcarbazepine. ( info)

2/411. Congenital insensitivity to pain with anhidrosis: a case report.

    Congenital insensitivity to pain with anhidrosis (CIPA) is a very rare genetic disorder of the peripheral nervous system characterized by recurrent episodes of unexplained fever, generalized anhidrosis, insensitivity to pain and temperature, and accompanied by self-mutilating behavior and mental retardation. We report on a 16 month-old boy with CIPA who exhibited these characteristic clinical features. A sural nerve biopsy revealed markedly reduced numbers of unmyelinated and small myelinated fibers, consistent with the characteristic features of CIPA. ( info)

3/411. female genital self-mutilation, dysorexia and the hysterical personality: the Caenis Syndrome.

    A detailed case report of female genital self-mutilation associated with dysorexia and the hysterical personality is presented. This lends support to recent literature that has suggested the possibility that these clinical features may comprise a discrete syndrome. The usefulness of considering this triad as a syndrome is illustrated by its facilitating the recall of two previous patients who in retrospect appear to fulfil these criteria. It is suggested that the name Caenis syndrome be given to this triad of behaviour. ( info)

4/411. False rape: a case report.

    A 16-year-old girl was admitted to the emergency department for sexual assault. The forensic examination revealed genital lesions of an age that were incompatible with her statements. She also presented extragenital lesions that resembled self-inflicted lesions. The reports of false rape allegations in the literature have all dealt with the motivations of the false victims. This case report is a reminder that an allegation of rape can be considered only on the basis of proof and not on speculation. ( info)

5/411. Hereditary sensory and autonomic neuropathy: review and a case report with dental implications.

    Hereditary sensory and autonomic neuropathy (HSAN) is a rare syndrome which is seen in early childhood. Five different types are described. Absence of pain and self-mutilation are characteristic findings of this syndrome. Teeth in the oral cavity can cause damage to the oral tissues and tongue. When it is diagnosed, there should be co-operation between dentist and neurologist. Using an oral shield prevents the biting and, thus, traumatization of the tissues can be prevented. A case report which is diagnosed as HSAN type 4 is presented and information submitted about its treatment. ( info)

6/411. Oral self-mutilation in a patient with rhombencephalosynapsys.

    Rhombencephalosynapsis (RS) is a rare cerebellar malformation. Its essential features are the absence of the incisura cerebelli posterior, fusion of the cerebellar hemispheres, the absence of the velum medullare anterius and nuclei fastigii, and fusion of the dentate nuclei, which are shifted towards the mid-line. Clinically, affected patients present with signs of cerebellar and motor disturbances. The present report describes a new patient affected by RS. The subject first presented at the age of 22 years because of a psychiatric symptomatology which was characterized by obsessive oral self-mutilation associated with an intellectual disability. Objective evaluation documented dysmorphic features, while neurological examination showed only a slight truncal ataxia. The subject's IQ was 74 on the Wechsler Scale (verbal IQ = 79, performance IQ = 74). Psychiatric evaluation with DSM-IV criteria documented an obsessive-compulsive personality disorder associated with emotional instability and oral self-mutilation. The typical picture of rhombencephalosynapsis was evident on magnetic resonance imaging. Both chromosomal analysis and routine biochemical investigations were normal. The relationship between oral self-injurious behaviour and cerebellar malformations is discussed with particular regard to the behavioural aspects of cerebellar congenital pathology in affective disorders and in autism. ( info)

7/411. Psychological treatment of self-injury.

    Behavioural treatment techniques were used for eliminating self-injurious behaviours of two mentally retarded patients. During treatment, each self-injurious response resulted in punishment followed by a timeout period and then differential reinforcement of other behaviours incompatible with self-injury. This procedure was effective in rapidly eliminating self-injury. ( info)

8/411. hyperphagia and self-mutilation in prader-willi syndrome: psychopharmacological issues.

    This study focused in the treatment of two major Prader-Willi symptoms: hyperphagia and self-injurious behavior (SIB). Four patients participated in a four-year study with monthly follow-ups. patients lived in a behaviorally structured environment, and were treated with selective serotonin reuptake blockers and phenothiazines. Psychopharmacological intervention improved SIB symptoms, but was ineffective to control appetite satiation. ( info)

9/411. Psychiatric and surgical management of male genital self-mutilation.

    Cases of genital self-mutilation are usually seen in the general hospital setting and can be difficult to manage especially in those patients who have psychiatric illness. A joint effort between the psychiatric and the surgical services will be required right from the beginning of hospital admission to diagnosis and later, to follow-up. Psychiatric consultation strategies at the different phases of intervention will be needed to cater for the special needs of the surgical team, patient and family. We describe three cases of genital self- mutilators and the general management of these patients. ( info)

10/411. Prevention of tongue biting with a removable oral device: a clinical report.

    A method of preventing tongue biting with a removal device has been described in this clinical report. Restraint of the tongue may be necessary to promote healing by preventing repetitive tongue biting or as a preventive measure after a surgery or an injury. Any device that is used to restrain the tongue should be removable to avoid prolonged interference with oral hygiene, swallowing, mastication, and speech. A removable device is desirable for long-term use by comatose or semicomatose patients. ( info)
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