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mds21723-MDS21723.mpg7863KFirst sequence. Patient before surgery in his ordinary environment. Several items of the BPI-1 (Behavior Problem Inventory) are positive. Self-mutilation behavior with severe lip biting and lip amputation. The hands are protected by gloves and permanently tied to the bed. Aggressive behavior against his environment with kicking/hitting his father. The patient is cruel with his mother during the breakfast. He is spitting the food on his mother.Second sequence. After surgery in the hospital. At rest, the four limbs are not tied to the bed and to the wheelchair, and protection of the fingers by the gloves is not necessary anymore. Bilateral simple manipulations are possible.

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