Severe self-injury in a young girl with autism spectrum disorder and Helsmoortel-van der Aa syndrome responding to naltrexone.
Gökçe Nur Durmaz, Nefise Kahraman, Murat Coşkun
✦ AI-curated · Sources linked
Case in brief
A 10-year-old nonverbal girl with autism spectrum disorder and Helsmoortel-van der Aa syndrome had chronic, severe self-injurious behavior (SIB), including ocular rupture. Multiple antipsychotic and benzodiazepine trials had provided limited benefit. After naltrexone was introduced, SIB frequency and severity declined by more than 50% within 4 weeks, with accompanying improvements in irritability and sleep and no reported adverse effects. Clinical Global Impression-Severity decreased from 7 to 4, and Clinical Global Impression-Improvement was rated 2.
What made this case unusual
The severe SIB caused ocular rupture in a nonverbal child with Helsmoortel-van der Aa syndrome, and declined after naltrexone was introduced following limited benefit from several prior medication trials.
Diagnostic / clinical pearl
In this case, naltrexone was associated with a marked reduction in treatment-resistant SIB; the report supports considering it as a possible adjunctive option, while further systematic investigation is needed.