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Vol. 66. Issue 2.
Pages 129-134 (1 February 2007)
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Vol. 66. Issue 2.
Pages 129-134 (1 February 2007)
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Tics en niños y adolescentes: análisis retrospectivo de 78 casos
Tics in children and adolescents: a retrospective analysis of 78 cases
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A. Catarina Prior, S. Tavares, S. Figueiroa, T. Temudo
Corresponding author
teresatemudo@netcabo.pt

Correspondencia: Dra. T. Temudo. Unidad de Neuropediatría. Servicio de Pediatría. Hospital Geral de Santo António, EPE. Largo Prof. Abel Salazar. 4099-011 Porto. Portugal.
Servicio de Pediatría. Hospital Geral de Santo António, EPE. Porto. Portugal
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Introducción

Los tics son el trastorno del movimiento más frecuente en la edad pediátrica. Es común la existencia de historia familiar de tics y de antecedentes familiares y personales de trastornos neurocomportamentales. Los tics pueden comprometer de modo importante las actividades de la vida diaria del individuo.

Objetivo

Estudio de las características de los tics de niños y adolescentes de la Consulta de Neuropediatría del Hospital Geral de Santo António.

Materiales y métodos

Análisis retrospectivo de los casos de tics usando la información recogida de las respectivas historias clínicas. Se utilizaron los criterios del Manual diagnóstico y estadístico de los trastornos mentales en su cuarta revisión de textos (DSM-IV-TR) de 2000, de la Asociación Americana de Psiquiatría.

Resultados

Fueron analizadas las historias clínicas de 78 individuos, 84,6 % de los cuales eran del sexo masculino. Más de un tercio de los casos pertenecía al grupo etario de los 4 a los 8 años de edad. En el 5,1% los tics se iniciaron antes de los 2 años. Historia familiar de tics, depresión y trazos de enfermedad obsesivo-compulsiva ocurrieron en aproximadamente un 30 % de los casos. La comorbilidad más frecuente fue el trastorno por déficit de atención e hiperactividad (TDAH) (67,9%). Se verificó la posible ocurrencia de trastorno neuropsiquiátrico autoinmune pediátrico (PANDAS) en 5 casos. Los tics motores precedieron a los vocales en todos los casos. En más de dos tercios los tics eran simples. En el 59,0 % de los casos los tics eran crónicos, y el 45,7 % de éstos cumplían criterios de trastorno de Gilles de la Tourette. El 43,1 % de los individuos con tics crónicos habían sido medicados, la mayoría con risperidona.

Conclusiones

De un modo general los resultados de este estudio son concordantes con los descritos en la literatura especializada, subrayándose la necesidad de considerar el diagnóstico en edades precoces, y señalándose la importancia de identificación y terapéutica adecuada de las comorbilidades.

Palabras clave:
Tics
Trastorno por déficit de atención con hiperactividad
Síndrome de Gilles de la Tourette
Introduction

Tics are the most frequent abnormal movement in children. A familial history of tics and a personal and familial history of neurobehavioral disturbances are common in children with this abnormality. Tics may seriously compromise daily activities in affected individuals.

Objective

To identify the characteristics of tics in children and adolescents followed-up in the Neuropediatric Unit of the Hospital Geral de Santo António.

Materials and methods

We performed a retrospective analysis of patients with tics based on information collected from medical records. The diagnostic criteria of the DSM IV-TR 2000 of the American Psychiatric Association were used.

Results

The medical records of 78 children were analyzed, 84.6% of whom were boys. More than one third of the patients were aged 4 to 8 years old. In 5.1% of the patients tics developed before the age of 2 years. A familial history of tics, depression and obsessive disorder traits was found in approximately 30 % of patients. The most frequent comorbidity was attention deficit hyperactivity disorder (67.9 %). The occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection (PANDAS) was suggested in five patients. In all patients, motor tics occurred before vocal tics. In more than two thirds of the patients, tics were simple. In 59.0% of the patients, tics were chronic, and in 45.7% of these met the criteria for Tourette's syndrome. A total of 43.1% of the patients with chronic tics received pharmacotherapy, risperidone being the most frequently used drug.

Conclusions

In general the results of the present study are in agreement with those of previous studies, underlining the need to consider a diagnosis of tics in young children and highlighting the importance of identification and appropriate treatment of comorbidities.

Key words:
Tics
Attention deficit hyperactivity disorder
Tourette's syndrome
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Copyright © 2007. Asociación Española de Pediatría
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