Sidow Nor Osman, Sheikh Hassan Mohamed
Department of Neurology, Somali Mogadişu Türkiye Recep Tayyip Erdoğan Research and Training Hospital, Somalia.
Ann Med Surg (Lond). 2022 Jun 28;79:104030. doi: 10.1016/j.amsu.2022.104030. eCollection 2022 Jul.
Autophagia occurs when one is compelled to inflict pain upon oneself by biting and/or devouring portions of one's body. It is sometimes associated with psychiatric disorders or with acquired nervous system lesions and could be life-threatening (The Journal of Nervous and Mental Disease, February 2012) [2]. It is the first time that this behavior was seen in post-stroke patients, not reported in the medical literature before. A 65-years-old male patient was seen in our emergency department with left side weakness, and agitation that he had self-mutilated his index finger as the same time for one day before admission. He has no previous history of psychiatric illnesses, only he had hypertension. Head CT showed hematoma in the right thalamic and basal ganglia, after orthopedic consultation, the terminal phalange of the index finger in the left hand was amputated, and antipsychotic drugs was started with significant recovery. So thalamic hemorrhage can cause agitation and self mutilating behavior. Autophagia could be classified under the DSM's Impulse-Control Disorders.Self-mutilation is a severe form of self-injury. Both involve a deliberate and direct injury to one's own body surface without suicidal intent (Claes and Vandereycken, 2007) (Resch et al., 2008) [5].
自体吞噬是指一个人被迫通过咬和/或吞食自己身体的部分来给自己造成痛苦。它有时与精神疾病或后天性神经系统损伤有关，可能危及生命（《神经与精神疾病杂志》，2012年2月）[2]。这是首次在中风后患者中观察到这种行为，此前医学文献中未报道过。一名65岁男性患者因左侧肢体无力被送至我院急诊科，入院前一天曾同时自残食指，伴有烦躁不安。他既往无精神疾病史，仅有高血压。头部CT显示右侧丘脑和基底节区血肿，经骨科会诊后，左手食指末节指骨被截肢，并开始使用抗精神病药物治疗，患者明显康复。因此，丘脑出血可导致烦躁不安和自残行为。自体吞噬可归类于《精神疾病诊断与统计手册》中的冲动控制障碍。自残是自我伤害的一种严重形式。两者都涉及对自己身体表面的故意和直接伤害，且无自杀意图（克莱斯和万德雷肯，2007年）（雷施等人，2008年）[5]。
