Department of Neuropsychiatry, University of Brescia, Brescia, Italy.
J Dev Behav Pediatr. 2012 Feb;33(2):184-6. doi: 10.1097/DBP.0b013e318244eb2f.
Bridgette is a 6-year-old girl, who presented with sudden onset of refusal to eat or drink. The only precipitating event was a nightmare the previous night. She described a dream in which her mother and maternal aunt, dressed as witches, and father and maternal uncle, appearing as bats, wanted to kill her by making her eat and drink from a cauldron. Bridgette stated, "I can't eat anymore, I'm afraid of dying." Bridgette's eating pattern and behavior were described as previously normal. Motor, social, and language milestones were also normal. Her parents reported that she occasionally refused nonpreferred foods, and they believed that her food intake had decreased at age 4 years. She was a full-term infant without perinatal problems and breast fed until 8 months. Her medical history was significant for strabismus surgery, before 6 months. Her mental health history revealed mildly depressed mood and irritability related to teasing at school after her strabismus surgery. Her parents described her as "always looking for attention." Her teachers reported that she had normal intelligence and described her behavior as shy, slightly withdrawn, and distrustful. Social history revealed an only child of married parents without marital or work-related problems. Bridgette went to her maternal grandmother's home after school and during school holidays.Her parents pleaded with her to eat, but she refused. She was evaluated at urgent care where her physical examination was described as normal. Her body mass index was above the 97th percentile (3 SD above the mean). The parents were described as fearful and despairing. Laboratory tests included a complete blood count with differential, an electroencephalogram, and a computed tomography scan, all of which were normal. Intravenous fluids were administered on the day of presentation and the following day. She continued to refuse to eat or drink, and after 2 days, she was hospitalized for nasogastric tube feeding.
布里奇特特是一个 6 岁的女孩，她突然拒绝进食或饮水。唯一的诱发事件是前一天晚上做了一个噩梦。她描述了一个梦，梦中她的母亲和阿姨打扮成女巫，父亲和叔叔则扮成蝙蝠，想让她吃一种从锅里舀出来的东西来杀她。布里奇特特说：“我不能再吃了，我害怕死。” 她的进食模式和行为以前都很正常。运动、社交和语言发育也都正常。她的父母报告说，她偶尔会拒绝不喜欢的食物，他们认为她从 4 岁起就减少了进食量。她是一个足月出生的婴儿，没有围产期问题，母乳喂养至 8 个月。她的医疗史中有斜视手术，手术在 6 个月前进行。她的心理健康史显示，斜视手术后，她的情绪有些抑郁和易怒，在学校里被人嘲笑。她的父母形容她“总是寻求关注”。她的老师报告说她智力正常，描述她的行为是害羞、有点孤僻和不信任他人。社会史显示，她是已婚父母的独生女，父母婚姻和工作没有问题。放学后和学校假期，她去祖母家。她的父母恳求她吃东西，但她拒绝了。她在紧急护理中心接受了评估，体检正常。她的体重指数高于第 97 个百分位（高于平均值 3 个标准差）。父母们感到恐惧和绝望。实验室检查包括全血细胞计数、脑电图和计算机断层扫描，均正常。就诊当天和第二天，她都接受了静脉补液。她继续拒绝进食或饮水，两天后，她因需要鼻胃管喂食而住院。
