A patient may present with self-biting of perioral structures (tongue, cheeks, lips), fingers, arms or other accessible structures. Diagnostic considerations depend on the age of the patient, age of onset and other clinical findings.
Differential diagnosis:
(1) mental retardation
(2) autism
(3) seizure disorder
(4) substance abuse (overdose, seizure, other)
(5) congenital indifference to pain
(6) Lesch-Nyhan syndrome
(7) psychiatric disorder (severe compulsion, psychosis)
Condition
Features
Absent
mental retardation
developmental delays, stigmata of inherited disorders
autism
profound withdrawal; obsessive desire to preserve sameness in environment; skillful with inanimate objects
seizure disorder
biting of perioral structures
biting of fingers and other sites
substance abuse
biting of perioral structures; usually adolescent or adult
biting of fingers and other sites
congenital indifference to pain
biting of perioral structures fingers and other sites; autosomal recessive
Lesch-Nyhan
biting of perioral structures fingers and other sites; hyperuricemia, hyperuricaciduria; choreoathetosis, spastic cerebral palsy; X-linked inheritance
psychiatric disorder
psychiatric comorbidity; adolescent or adult; biting of perioral structures fingers and other sites
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