Master A, 6 year old boy, primary school student, New
Delhi resident, member of nuclear family of lower socio-economic strata,
presented with 1st episode of abrupt onset of illness with duration of 48 h,
characterized by excessive irritability, increased activity, crying spells,
hitting and biting others, not sleeping and refusal to eat. Detailed work-uprevealed the child was born at term by normal vaginal delivery without anyperinatal complications. His developmental milestones were attained on time as
per his age at the time of presentation. Premorbidly, he had been an easy child
with good scholastic performance and no past history of any major medical or
surgical condition. There was no history of head injury, loss of consciousness,
unknown substance ingestion, any stressful event, or any form of abuse, at the
child’s house or school.
Physical examination did not reveal any abnormality.
However, child appeared disoriented and kept asking for his mother in spite of
sitting on her lap.Mental status examination revealed a young male child withmarkedly increased psychomotor activity, ill sustained eye to eye contact, and
irritable affect with frequent crying.
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