Assessment of Aggressive Behaviour in a Patient with Autism Spectrum Disorder Requiring General Anesthesia.

OBJECTIVE

To consider the utility of general anesthesia in the assessment of aggressive behaviour associated with autism spectrum disorder (ASD).

METHODS

We describe the case of an adolescent male exhibiting violent behaviour with a previous diagnosis of ASD and review medical literature relevant to the assessment of aggression in the context of ASD.

RESULTS

A 16-year-old male with a prior diagnosis of ASD, who was non-verbal, was admitted to an inpatient psychiatry ward with the presenting issue of violent behaviour. The patient had not received routine medical or dental care for several years due to agitation and aggression when attempts to physically examine him were made. General anesthesia was necessary to assess for medical conditions that may be contributory to his behavioural changes. While under general anesthesia, he was physically examined by several consulting services, received brain imaging, and laboratory specimens were drawn.

CONCLUSIONS

Aggressive behaviour is a common issue for patients with ASD. When a patient's behaviour precludes examination and investigations, general anesthesia may be beneficial to facilitate the assessment process. This case illustrates the importance of a multidisciplinary approach in the assessment and management of a minimally verbal patient presenting with behavioural changes. To the knowledge of the authors, this represents the first published case report of a patient with ASD requiring general anesthesia for the assessment of aggressive behaviour.