Clinical Scorecard: Management of Post-Traumatic Aggression in a Child with Traumatic Brain Injury: A Case Study on Long-Acting Injectable Paliperidone and a Review of Relevant Literature

At a Glance

Key Highlights

• LAI paliperidone significantly reduced aggression in a child with severe TBI.
• Functional status improved from Rancho Los Amigos Level IV to Level VIII.
• Adverse effects were limited to weight gain and asymptomatic hyperprolactinemia.

Guideline-Based Recommendations

Diagnosis

• Assess for post-traumatic confusional state and behavioral dysregulation in TBI patients.

Management

• Consider long-acting injectable paliperidone for patients with poor adherence to oral medications.

Monitoring & Follow-up

• Monitor for weight gain and hyperprolactinemia in patients receiving paliperidone.

Risks

• Potential for spontaneous recovery; careful consideration needed before pharmacological intervention.

Patient & Prescribing Data

Children and adolescents with severe TBI and behavioral dysregulation.

LAI paliperidone can stabilize severe behavioral dysregulation when oral adherence fails.

Clinical Best Practices

• Utilize a multidisciplinary approach for managing TBI-related behavioral issues.
• Prioritize patient safety and monitor for adverse effects during treatment.

References

• Case Study on LAI Paliperidone
• Pharmacological Management of TBI