Severe self-injury in a young girl with autism spectrum disorder and Helsmoortel-van der Aa syndrome responding to naltrexone.

Psychiatr GenetAug 18, 2026 (epub)
Case ReportPsychiatryPediatricsMedical Genetics

Gökçe Nur Durmaz, Nefise Kahraman, Murat Coşkun

✦ AI-curated · Sources linked

Case in brief

A 10-year-old nonverbal girl with autism spectrum disorder and Helsmoortel-van der Aa syndrome had chronic, severe self-injurious behavior (SIB), including ocular rupture. Multiple antipsychotic and benzodiazepine trials had provided limited benefit. After naltrexone was introduced, SIB frequency and severity declined by more than 50% within 4 weeks, with accompanying improvements in irritability and sleep and no reported adverse effects. Clinical Global Impression-Severity decreased from 7 to 4, and Clinical Global Impression-Improvement was rated 2.

What made this case unusual

The severe SIB caused ocular rupture in a nonverbal child with Helsmoortel-van der Aa syndrome, and declined after naltrexone was introduced following limited benefit from several prior medication trials.

Diagnostic / clinical pearl

In this case, naltrexone was associated with a marked reduction in treatment-resistant SIB; the report supports considering it as a possible adjunctive option, while further systematic investigation is needed.

Source

PubMed · PMID 42704315

Published in Psychiatr Genet. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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