Tics are the most common movement disorder in childhood and are a frequent reason for referral to child neurology clinics. The purpose of this review is to examine the phenomenology of tics, discuss what is known regarding their genetic and pathophysiological causes and to evaluate current treatment options. The evidence for the evaluation and treatment of the controversial diagnosis of pediatric autoimmune neuropsychiatric disorders associated with group A streptococci (PANDAS) will also be reviewed. With improved understanding of tic disorders, their etiology and response to current treatment options, we may be able to more effectively diagnose them and identify novel treatment strategies.
Autoimmune Diseases , Mental Disorders , Streptococcal Infections , Tic Disorders , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Child , Humans , Mental Disorders/diagnosis , Mental Disorders/therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Tic Disorders/diagnosis , Tic Disorders/etiology , Tic Disorders/physiopathology , Tic Disorders/therapy
Investigators from Centre de Reference National Maladie Rare 'Syndrome Gilles de la Tourette' and Sorbonne University report white matter abnormalities in the pathways connecting the cerebral cortex, basal ganglia, and thalamus in a group of 49 adults with Tourette syndrome (TS).
Anxiety/diagnosis , Dystonia/diagnosis , Myoclonus/diagnosis , Adolescent , Anti-Dyskinesia Agents/therapeutic use , Anxiety/complications , Anxiety/genetics , Diagnosis, Differential , Dystonia/complications , Dystonia/genetics , Genetic Testing , Hand/physiology , Head Movements , Humans , Male , Marfan Syndrome/physiopathology , Movement , Myoclonus/complications , Myoclonus/genetics , Neurologic Examination , Posture/physiology , Sarcoglycans/genetics , Speech/physiology , Speech Disorders/etiology , Trihexyphenidyl/therapeutic use
There is increasing need for both consensus definitions and continued research into the causes, clinical spectrum, and treatment of pediatric movement disorders. Treatment has been largely based on experience rather than evidence because clinical trials are limited. With development of consensus definitions, identification of causative genes, understanding of the clinical spectrum of disease, and clinical trials, we can provide overall better care for children with movement disorders. This review highlights 5 areas where progress is being made to achieve these goals in pediatric movement disorders.
The authors report a case of a 7-year-old girl with a progressive sensorimotor peripheral neuropathy with acute relapses associated with a desquamating purpuric rash, alopecia, and spinal cord atrophy. Distinctive features include systemic involvement with alopecia and rash, peripheral nervous system involvement with relapsing and remitting sensorimotor neuropathy, and central nervous system involvement with episodes of dystonic posturing and spinal cord atrophy. Extensive diagnostic evaluation for known causes of skin manifestations associated with peripheral neuropathy has failed to identify a cause for this patient's condition. The authors discuss the case as an approach to the differential diagnosis and to highlight unusual features of this yet to be identified clinical entity.
Exanthema/pathology , Peripheral Nervous System Diseases/pathology , Spinal Cord/pathology , Atrophy/pathology , Child , Disease Progression , Female , Humans , Recurrence
