# A Case Report on Early-Onset Misophonia in a Bangladeshi Pediatric Patient

## TL;DR

A nine-year-old Bangladeshi boy with early-onset misophonia showed emotional reactions to specific sounds and later developed OCD-like behaviors, highlighting the need for early diagnosis and individualized treatment.

## Contribution

This case report highlights early-onset misophonia in a child with visual and auditory triggers and its overlap with OCD, emphasizing the importance of early diagnosis and tailored treatment.

## Key findings

- The patient exhibited emotional reactions to specific auditory and visual triggers from a young age.
- The case shows misophonia can co-occur with OCD symptoms and requires individualized treatment approaches.
- Early diagnosis and attention to comorbidities are crucial for effective management.

## Abstract

This case report describes a nine-year-old Bangladeshi boy with misophonia symptoms beginning at three years old, an underreported condition in children. He exhibited strong emotional reactions to specific sounds made by his mother, such as yawning and breathing, which later extended to visual triggers, including her nose-scratching. He attempted to stop these triggers through physical actions. Autism was ruled out. A brief trial of sertraline, risperidone, and behavioral therapy showed minimal benefit and was discontinued. In the fifth year, compulsive hand-washing emerged. Family history revealed parental OCD. On reevaluation, he was diagnosed with misophonia and emerging OCD. Treatment included selective serotonin reuptake inhibitors, cognitive behavioral therapy with exposure and response prevention, relaxation techniques, and follow-up. This case underscores the potential for early-onset misophonia with auditory and visual triggers, its overlap with OCD, and the need for early diagnosis, attention to comorbidities, and individualized, ongoing care.