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Abstract

INTRODUCTION: Neurofibromatosis type 1 (NF1) is a genetic disorder caused by a mutation in the NF1 gene. In addition to physical manifestations, complications such as cognitive and behavioral deficits have been described. CLINICAL FINDINGS: We describe a case of a 14-year-old male with a past psychiatric history of obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and multiple suicide attempts, who presented with suicidal ideation and command hallucinations. The patient became aggressive, physically assaulting hospital staff, and required sedative medication and physical restraints for several days. He required inpatient hospital admission due to rhabdomyolysis. Throughout his admission, the patient was intermittently verbally and physically abusive to people around him. They described his outbursts as impulsive and thought to be out of motivation to get what he wants. He preferred to keep to himself and did not have relationships with people at his home. CONCLUSION: This case report provides insight into the behavioral characterization of children diagnosed with NF1. While the mechanism of how NF1 relates to behavioral issues is unknown, the association between NF1 and behavioral issues should be carefully considered in NF1 patients presenting with aggression.

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