舌咽神経痛によりPTSD様症状を発症した発達障害女児の1症例

A Girl with Developmental Disorder who Developed PTSD-like Symptoms due to Glossopharyngeal Neuralgia

要旨

　16歳，女児，歯科矯正器具抜去後から舌根部，咽頭部に発作性の激痛が生じた。磁気共鳴画像（MRI）検査で右舌咽神経に前下小脳動脈が近接しており，舌咽神経痛と診断した。そのあと，舌咽神経痛の増悪で心的外傷後ストレス障害様症状を発症し，早期の多職種による集学的治療が有効であった発達障害女児の1症例を経験したので報告する。

　We report the case of a 16-year-old girl with developmental disorder who developed post-traumatic stress disorder（PTSD）-like symptoms due to an exacerbation of glossopharyngeal neuralgia and who benefited from early multidisciplinary treatment by a multidisciplinary team. The patient had attention deficit hyperactivity disorder（ADHD）and autism. After the removal of an orthodontic appliance the patient developed paroxysmal severe pain at the root of the tongue and pharynx, and she was diagnosed as having glossopharyngeal neuralgia. She refused to take carbamazepine, due to her developmental disorder. Her symptoms worsened despite continued medical treatment. After the patient’s visit to our hospital, multidisciplinary staff intervened at an early stage. She was administered carbamazepine, and her pain was well controlled. However, 1 month after her initial visit, she developed PTSD-like symptoms. Her ADHD was thought to be the cause of her obsession and hyperalgesia. She improved with multidisciplinary treatment and environmental modifications at school.