Attention deficit hyperactivity disorder (ADHD) is a life-long neurodevelopmental disorder and treatment depends on pharmacotherapy because of its biological origin. Stimulant drugs are the most commonly used treatment for ADHD and they have various side effects. Herein, we report a case who bit off the tip of her tongue with Osmotic Release Oral System methylphenidate (OROS MPH) 36 mg/day, bit the tip of her lower lip with immediate release (IR) MPH 10 mg/day and lateral part of her tongue with IR MPH 20 mg/day. A diagnosis of epilepsy was unlikely because of the normal neurological examination and electroencephalography findings. This case was considered as an atypical side effect of MPH such as perseverative/compulsive behaviours and movement disorders. Clinicians should be aware of that stimulant medications may cause lip and tongue biting behavior and this may effect treatment compliance tremendously.
Attention Deficit Disorder with Hyperactivity ; Compliance ; Diagnosis ; Drug Therapy ; Electroencephalography ; Epilepsy ; Lip* ; Methylphenidate* ; Movement Disorders ; Neurodevelopmental Disorders ; Neurologic Examination ; Stereotypic Movement Disorder ; Tongue*

Encephalitis lethargica (EL) is an acute or subacute central nervous system (CNS) infectious disorder presenting with pharyngitis followed by sleep disorder, basal ganglia signs (particularly parkinsonism), and neuropsychiatric sequelae. We report a 67-year-old man who had hypersomnolence, oculogyric crisis, akinetic mutism, parkinsonism, and malignant catatonia, which represented the stereotypic movement disorder with additional features of hyperthermia. His symptoms dramatically improved after steroid pulse therapy, indicating that EL syndrome could be a postinfectious neurological autoimmune CNS disorder.
Aged ; Akinetic Mutism ; Basal Ganglia ; Catatonia ; Central Nervous System ; Disorders of Excessive Somnolence ; Encephalitis ; Fever ; Humans ; Parkinsonian Disorders ; Pharyngitis ; Stereotypic Movement Disorder

Motor disorders in childhood include tic disorder, developmental coordination disorder, and stereotypic movement disorder. A tic is a sudden, rapid, repetitive and nonrhythmic movement (motor tics) or phonic production (phonic or vocal tics) that can occur at any part of the body. Developmental coordination disorder (DCD) is characterized by marked impairment in the acquisition and performance of motor skills. Stereotypic movement disorder is a common childhood disorder which repetitive, hard to control, aimless motor activity interrupts everyday life or causes self-infliction of a child. Despite increased attention and the growing scientific knowledge about motor disorders, there are limitations in our understanding and knowledge about the pathogenesis and the management of the disorders. Motor disorders can itself be the primary diagnosis, or can be secondarily diagnosed caused by other disorders, and accompany many neuropsychiatric disorders such as autism and attention deficit hyperactivity disorder (ADHD), which in turn impairs proper learning and socializing of the children with motor disorders. Therefore comprehensive medical history taking, continuous observation of the changes in symptoms, and systematic assessment considering the child's developmental stage and current adaptive capacity are needed. Behavioral therapy and pharmacological therapy are the two most often mentioned treatments of motor disorders.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Autistic Disorder ; Child ; Diagnosis ; Humans ; Learning ; Medical History Taking ; Motor Activity ; Motor Skills ; Motor Skills Disorders ; Stereotypic Movement Disorder ; Tic Disorders ; Tics* ; Tourette Syndrome*