Treatment strategies for a case of concurrent pervasive developmental disorder and cerebral gigantism

A 4-year-old girl presented for a psychiatric evaluation with reported episodes of clumsiness, aggressiveness, lack of relatedness, and temper tantrums. Her evaluation disclosed multiple developmental deficits, including cognitive, affective, and social lags. Given her individual history and her specific constellation of symptoms as well as a familial history indicative of developmental impairment, the child was diagnosed as having pervasive developmental disorder. This diagnosis reflects the expanded nosology for autism, as specified in DSM-III-R. Subsequently, after a genetic evaluation, the child was found to have an organic central nervous system deficit in the form of cerebral gigantism, a neural disorder. The recognition of an organic impairment in this case contributed to an understanding of the pervasive developmental disorder symptomatology and facilitated the formulation of an appropriate therapeutic protocol that addressed both developmental and neurological components.