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

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.