Self-mutilation is a behavioral disturbance characterized by the deliberate destruction of or damage to body tissues. This case report describes a 7-year-old child reported with multiple ulcerations in the oral cavity due to self-biting. Intraoral examination showed ulcerations on the left and right buccal mucosa and tongue. Medical history revealed history of fever accompanied by acute onset of flaccid paralysis and encephalopathy. Magnetic resonance imaging brain was suggestive of acute viral meningoencephalitis. Japanese encephalitis (JE) infection was confirmed by immunoglobulin M (IgM) detection. The damage due to self-biting was progressive in nature and the patient\'s condition did not improve on medication. Extractions of permanent teeth were carried out under local anesthesia to prevent the self-injurious behavior (SIB).
Solomon T, Dung NM, Kneen R, Gainsborough M, Vaughn DW, Khanh VT. Japanese encephalitis. J Neurol Neurosurg Psychiatry 2000 Apr;68(4):405-415.
Solomon T. Flavivirus encephalitis. N Engl J Med 2004 Jul;351(4):370-378.
Burke DS, Lorsomrudee W, Leake CJ, Hoke CH, Nisalak A, Chongswasdi V, Laorakpongse T. Fatal outcome in Japanese encephalitis. Am J Trop Med Hyg 1985 Nov;34(6):1203-1210.
Mishra MK, Basu A. Minocycline neuroprotects, reduces microglial activation, inhibits caspase 3 induction, and viral replication following Japanese encephalitis. J Neurochem 2008 Jun;105(5):1582-1595.
Raung SL, Kuo MD, Wang YM, Chen CJ. Role of reactive oxygen intermediates in Japanese encephalitis virus infection in murine neuroblastoma cells. Neurosci Lett 2001 Nov;315(1-2):9-12.
Sebastian L, Desai A, Shampur MN, Perumal Y, Sriram D, Vasanthapuram R. N-methylisatin-beta-thiosemicarbazone derivative (SCH 16) is an inhibitor of Japanese encephalitis virus infection in vitro and in vivo. Virol J 2008 May;5:64.
Briere J, Gil E. Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. Am J Orthopsychiatry 1998 Oct;68(4):609-620.
Nock MK, Prinstein MJ. A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol 2004 Oct;72(5):885-890.
Simeon D, Favazza AR. Self-injurious behaviors: Phenomenology and assessment, in Self-Injurious Behaviors: Assessment and Treatment, eds Simeon D, Hollander E, editors. (Washington, DC: American Psychiatric Publishing;), pp. 1-28.
Saemundsson SR, Roberts MW. Oral self-injurious behavior in the developmentally disabled: review and a case. ASDC J Dent Child 1997 May-Jun;64(3):205-209, 228.
Nabonita S, Anirban B. Japanese encephalitis virus infection: effect on brain development and repair. Curr Sci 2013 Sep;105(6):815-820.