[Sexual assault and post-traumatic stress disorder]

Sexual assault is an assault on the physical and psychological integrity of the child. She is qualified when it is incest within the family. The posttraumatic stress disorder is a psychological reaction that can be substantial. Mr B. Nabil aged 25 was hospitalized for a psychiatric depressive syndrome. At the age of 6, his older brother was sexually assaulted. The child took refuge in silence and presented problems which regressed spontaneously rained a few weeks later. His adolescence was marked by relational instability, impulsivity and manifest a tendency to consumption of toxic substances. In adulthood, he enlisted in the army which he could difficultly adapted to the new situation until to the occurrence of an incident [sexual advances by a friend] who reactivated her painful memories. He presented a state of post-traumatic stress disorder complicated by depression and decided to break the silence wanting consultant in psychiatry. The posttraumatic stress disorder and depression are psychological consequences of sexual assault. The disclosure process is long, complex and painful. A multidisciplinary approach allowed the patient to overcome the shame, guilt and fear and to manage invasive and painful memories. The state of posttraumatic stress may persist for several years in the absence of treatment. An early care, sensitive and multidisciplinary improves prognosis

[ neuroleptic malignant syndrome]

This is one of the serious complications that can occur at any time during treatment with neuroleptics. Its prevalence is estimated at 0.01% - 0.02% in patients treated with neuroleptics. Patient aged 19 years hospitalized in psychiatry for schizophreniform disorder and put on haloperidol 15 mg / day chlorpromazine 200 mg / day. Fifteen days after admission, he shozed gradually: generalized muscle rigidity, difficulty walking and fatigability. All operating in a context of confusion and hyperthermia at 38.5[degree sign] C. determination of CPK was 2396 IU / l. Given this clinical picture, the diagnosis of neuroleptic malignant syndrome was made and the neuroleptic treatment was stopped and the patient put under massive diazepam with rehydration and strict clinical supervision. The clinical and biological evolution was favorable, and he was put under Olanzapine. The patient was young. Neuroleptic malignant syndrome occurred two weeks after the introduction of neuroleptic treatment with haloperidol [15 mg / day] and chlorpromazine [200 mg / day]. The clinical picture is limited to generalized muscle rigidity, confusion, hyperthermia at 38.5 and elevated CPK [2396 UI / l]. Stopping the treatment in question, correction of fluid and electrolyte disorders and prescription of a benzodiazepine conduct to a favorable evolution two weeks later. A practitioner should suspect a neuroleptic malignant syndrome before unexplained hyperthermia in a patient under neuroleptic. Immediate discontinuation of neuroleptic therapy and general measures of resuscitation is the mainstay of treatment