Wright Barry, Beverley David
Child, Adolescent & Family Unit, York, England, UK.
Clin Child Psychol Psychiatry. 2012 Apr;17(2):221-8. doi: 10.1177/1359104511403680. Epub 2011 Jul 6.
We report here on a case of severe pervasive refusal syndrome. This is of interest for three reasons. Firstly, most reported cases are adolescent girls; our case is regarding an adolescent boy. Secondly, he was successfully treated at home and thirdly, the serology showed an apparent infective pre-cursor to the illness with evidence of possible autoimmune serology. A 14-year old boy deteriorated from a picture where diagnosed CFS/ME developed into Pervasive Refusal Syndrome. This included the inability to move or speak, with closed eyes, multiple tics, facial grimacing, heightened sensitivity to noise (hyperacusis) and touch (hyperaesthesia), and inability or unwillingness to eat anything except small amounts of sloppy food. Successful rehabilitation is reported. Finally the issue of nomenclature is discussed, raising the question whether Pervasive Refusal Syndrome would be better renamed in a way that does not imply that the condition is always volitional and oppositional, as this can distract focus away from an alliance between family and clinicians.
我们在此报告一例严重的广泛性拒绝综合征病例。该病例之所以引人关注，有三个原因。其一，大多数已报道的病例是青春期女孩；而我们的病例是一名青春期男孩。其二，他在家中得到了成功治疗。其三，血清学检查显示该疾病存在明显的感染前驱因素，并有自身免疫血清学的证据。一名14岁男孩从被诊断为慢性疲劳综合征/肌痛性脑脊髓炎的状态恶化为广泛性拒绝综合征。这包括无法移动或说话、双眼紧闭、频繁抽搐、面部怪相、对噪音（听觉过敏）和触摸（感觉过敏）高度敏感，以及除了少量稀软食物外无法或不愿进食任何东西。报告称康复成功。最后讨论了命名问题，提出了广泛性拒绝综合征是否应更好地重新命名的问题，因为目前的名称可能暗示这种情况总是出于意志和对立的，而这可能会分散对家庭与临床医生之间合作关系的关注。
