pica and Brain-Damage--Chronic

Topics: Achievement; Autistic Disorder; Behavior Therapy; Brain Damage, Chronic; Child; Child, Institutionalized; Child, Preschool; Counseling; Family; Humans; Hyperkinesis; Intellectual Disability; Intelligence; Language Disorders; Mental Disorders; Personality; Pica; Play Therapy; Psychotherapy; Psychotic Disorders; Social Isolation; Stereotyped Behavior; Temperament

A 28-year-old woman with acquired brain damage suffered subsequent profound mental disability and an intense hyperphagic syndrome complete with life-threatening pica. She was the single subject of two consecutive experiments. In the first, Naltrexone, an orally administered opiate blocker, was given to reduce hyperphagia and distress, but was associated with even greater urgency when eating meals and a manifest increase in distress. While distress reduced to premedication levels on withdrawal of treatment, urgency of eating did not reduce so quickly. In the second experiment a laser acupuncture procedure was used at 2.5 Hz and 10 Hz for 10 days each with an intervening 10-day placebo condition to increase the availability of the subject's endogenous opiates, and thus hopefully produce opposite effects to the first experiment and effect a positive treatment. The 10 Hz condition produced a significant but transient reduction in pica measured by attempts at pica on a supervised walk shortly after each treatment. The subject was also easier to manage on walks, and appeared happier. Further studies using physical exercise or acupressure to achieve similar or better results are discussed.

Topics: Acupuncture Therapy; Adult; Brain Damage, Chronic; Dose-Response Relationship, Drug; Drug Administration Schedule; Feeding Behavior; Female; Humans; Hyperphagia; Lasers; Naltrexone; Narcotic Antagonists; Opioid Peptides; Pica; Treatment Outcome; Ventromedial Hypothalamic Nucleus

Topics: Brain Damage, Chronic; Chelating Agents; Child, Preschool; Chronic Disease; Environmental Exposure; Female; Humans; Infant; Lead; Lead Poisoning; Male; Pica