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一名患有慢性疼痛儿童的未确诊自闭症谱系障碍:病例报告

Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report.

作者信息

Byl Maelle, Morere Anne-Charlotte, Fonteyne Christine

机构信息

Pediatrics, Hopital Universitaire de Bruxelles, Brussels, BEL.

Psychiatry, Hopital Universitaire de Bruxelles, Brussels, BEL.

出版信息

Cureus. 2024 Mar 26;16(3):e56946. doi: 10.7759/cureus.56946. eCollection 2024 Mar.

Abstract

The literature acknowledges the presence of psychiatric comorbidities in pediatric chronic pain populations. Few studies have focused on comorbidity with autism spectrum disorders. We describe the case of a 10-year-old patient at the onset of his care by the chronic pain team. This boy had been experiencing refractory multifocal chronic pain for three years and had undergone multiple medical examinations that had not identified the cause of the pain or provided sufficient pain relief. During our consultations, the behavioral peculiarities (averted gaze, inhibition), the atypical description of this boy's pain (pain in the hair), and sensory peculiarities (intolerance to noise) led us to suspect an autism spectrum disorder. A multidisciplinary approach, including a thorough developmental history and evaluation by an autism resource center, confirmed this suspicion. The diagnosis of an underlying autism spectrum disorder allowed us to guide our management by integrating the specific sensory aspects of this boy. Concurrently, we facilitated the family's better understanding of the young boy's issues and addressed his social and communication difficulties. Through multidisciplinary care and the integration of these various aspects, our patient's clinical situation improved. Multidisciplinary management is essential in chronic pain teams.

摘要

文献承认儿科慢性疼痛人群中存在精神疾病共病情况。很少有研究关注与自闭症谱系障碍的共病情况。我们描述了一名10岁患者在慢性疼痛团队开始对其进行治疗时的病例。这个男孩三年来一直遭受难治性多灶性慢性疼痛,并且已经接受了多次医学检查,但这些检查并未找出疼痛原因,也未提供足够的疼痛缓解。在我们的会诊过程中,其行为特点(目光回避、抑制)、对疼痛的非典型描述(头发疼痛)以及感觉特点(对噪音不耐受)使我们怀疑他患有自闭症谱系障碍。包括详尽的发育史以及由自闭症资源中心进行评估在内的多学科方法证实了这一怀疑。潜在自闭症谱系障碍的诊断使我们能够通过整合这个男孩的特定感觉方面来指导我们的治疗。同时,我们帮助这个家庭更好地理解这个小男孩的问题,并解决他的社交和沟通困难。通过多学科护理以及这些不同方面的整合,我们患者的临床状况得到了改善。多学科管理在慢性疼痛团队中至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5942/11044078/9154aecdafea/cureus-0016-00000056946-i01.jpg

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