Morbid hunger and hyperphagia post-traumatic brain injury in a young male: good prognosis with escitalopram and multidisciplinary rehabilitation

• Published in: BRAIN INJURY
• Main Authors: Zainudin, Muhamad Faizal; Yee, Cha Mei; Yin, Khin Nyein
• Format: Article; Early Access
• Language: English
• Published: TAYLOR & FRANCIS LTD 2024
• Subjects: Neurosciences & Neurology; Rehabilitation
• Online Access: https://www-webofscience-com.uitm.idm.oclc.org/wos/woscc/full-record/WOS:001270389700001

ObjectiveMorbid hunger and hyperphagia (MHH) is a rare neurological disorder that can manifest following damage to the right frontal and temporal lobes. It can lead to detrimental short and long-term complications such as electrolyte imbalances, obesity, and cardiovascular diseases. This report details the case of a young male patient who developed MHH five months post-traumatic brain injury.MethodSingle-case report. The patient exhibited colossal appetite, overeating, food-demanding behavior, and rapid weight gain. The prescription of quetiapine to manage his visual and auditory hallucinations was suspected of exacerbating the hyperphagia. A comprehensive, multidisciplinary rehabilitation approach was implemented, encompassing a meticulous dietary regime, environmental modifications, behavioral management, physical activities, therapeutic exercises, and pharmacological interventions, which included switching the anti-psychotics and introducing low-dose escitalopram.ResultsOver the course of 6 months, the MHH gradually subsided, and the patient achieved the target bodyweight. The Glasgow Outcome Scale-Extended improved from 3 to 5.ConclusionThis is the first report on the use of escitalopram to manage secondary eating disorders. Our findings underscore the necessity to formally catalog and recognize disorders like MHH in diagnostic classifications to facilitate the systematic study of their pathophysiology, natural history, prognosis, and management strategies.