Self-Injurious Behavior in Acquired Sensory Neuropathy

Abstract

Self-abusive behavior, noted frequently in congenital sensory neuropathy, was observed in two children with acquired peripheral nerve dysfunction. In one case a laceration over the median nerve was followed by self-induced trauma to the fingers distal to the cut, while the other patient developed self-mutilation in all the extremities following insecticide poisoning and presented with signs of diffuse peripheral neuropathy. Improvement of the self-injurious behavior in each case seemed temporally related to the use of anticonvulsant medications, a treatment that is often suggested for older patients with paresthesias related to peripheral neuropathy. The apparent improvement in these two patients suggests that a trial of these drugs in additional patients with self-abusive behavior associated with peripheral neuropathy would be justified.

Self-injurious behavior (SIB) in children, self-inflicted injury which tends to be repetitive and purposeless, has been associated with many disorders, including Lesch-Nyhan syndrome, mental retardation, autism, and congenital sensory neuropathy. We report two cases of self-mutilation which occurred as a result of acquired peripheral neuropathy. In both cases the self-mutilation appeared to improve with anticonvulsant therapy, a treatment often suggested in older patients for paresthesias associated with peripheral neuropathy.

Key words

Sensory neuropathy - Self injurious behavior - Anticonvulsants