As of 2011, it is not included in the standard psychiatric classification systems. Clin Child Psychol Psychiatry.В 2012 Apr 17(2):221-8. Pervasive refusal syndrome (PRS) is a rare but serious child psychiatric disorder that was first described by Bryan Lask and colleagues in 1991. Finally the issue of nomenclature is discussed, raising the question whether Pervasive Refusal Syndrome would be better renamed in a way that does not imply that the condition is always volitional and oppositional, as this can distract focus away from an alliance between family and clinicians. This included the inability to move or speak, with closed eyes, multiple tics, facial grimacing, heightened sensitivity to noise (hyperacusis) and touch (hyperaesthesia), and inability or unwillingness to eat anything except small amounts of sloppy food. IntroductionPervasive Refusal Syndrome was first described in the UK in 1991 by Lask and colleagues, when they described four girls aged 9-14 who presented with 'a potentially life threatening condition manifested by a profound and pervasive refusal to eat, drink, walk, talk, or care for themselves in any way over a period of several months'. A 14-year old boy deteriorated from a picture where diagnosed CFS/ME developed into Pervasive Refusal Syndrome. Secondly, he was successfully treated at home and thirdly, the serology showed an apparent infective pre-cursor to the illness with evidence of possible autoimmune serology. It is a rare disorder first described by Ellern Mede founder, Bryan Lask and colleagues in 1991 (until 2011 this was included in the standard psychiatric classification system, the DSM. Firstly, most reported cases are adolescent girls our case is regarding an adolescent boy. pervasive refusal syndrome (PRS) this is now referred to as pervasive arousal withdrawal syndrome (PAWS). We report here on a case of severe pervasive refusal syndrome.