Childhood Disintegrative Disorder as a Complication of Chicken Pox

By Verma, Jitendra; Mohapatra, Satyakam | Indian Journal of Psychological Medicine, January-February 2016 | Go to article overview

Childhood Disintegrative Disorder as a Complication of Chicken Pox


Verma, Jitendra, Mohapatra, Satyakam, Indian Journal of Psychological Medicine


Byline: Jitendra. Verma, Satyakam. Mohapatra

Childhood disintegrative disorder (CDD) is characterized by late onset (>3 years of age) of developmental delays in language, social function and motor skills. Commonly there is no antecedent physical disorder leading to childhood disintegrative disorder. The present case report describes a child who developed childhood disintegrative disorder at the age of 6 years after an episode of chicken pox.

Introduction

CDD, also known as Heller's syndrome or disintegrative psychosis, is a rare condition (1.7 cases per 100,000) [sup][1] characterised by late onset (>3 years of age) of developmental delays in language, social function and motor skills. It is grouped with the pervasive developmental disorders (PDDs) and is related to the better known and more common disorder of autism. Although recognised for many years, research on this condition is less advanced than that in autism. Commonly there is no antecedent physical disorder leading to CDD. The present case report describes a child who developed CDD at the age of 6 years after an episode of chicken pox.

Case Report

Master D, 8 years and 1 month old child, was admitted with chief complaints of hyperactivity, increased talkativeness and no social reciprocity since last 2 years. It was first continuous episode of illness precipitating after an episode of chicken pox. History of present illness revealed an episode of fever with rash, diagnosed to be chicken pox for a period of 15 days about 2 years ago. After 15 days of asymptomatic period, the patient developed fearfulness, decreased social interaction and decreased speech production for next 2 months. After this, gradually patient developed new symptoms - continuous irrelevant speech, verbal stereotypy, markedly increased motor activity, no social and emotional reciprocity, no eye to eye contact, decreased performance in activities of self help. Sleep of patient was normal. The above mentioned symptoms developed within a period of 1 month and were stable after that. Antenatal, natal, postnatal and period of infancy revealed no abnormality. Developmental history revealed normal development of child till the onset of chicken pox. He was average in studies. He had normal interaction with his family member and peer group. He had no history of any physical or psychiatric illness in the past. There was no family history of any neuropsychiatric illness. On physical examination, no abnormality, including any neurological sign was detected. MRI of brain showed no abnormality. Electroencephalogram (EEG) showed occasional bursts of spike and sharp wave discharges, though clinically there was no evidence of seizure disorder.

In the ward, child would remain hyperactive most of the time and would run here and there without any purpose. He had to be restrained in the lap of parents to be controlled. He would not show any interest in the surrounding and people around. He would not show any regard to presence or absence of his parents. When someone would try to talk to him, he would not make eye to eye contact and would continuously utter irrelevant things. …

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