title: Colour Doppler echocardiography in children with group A streptococcal infection related tic disorders.
abstract: OBJECTIVE
  A possible relationship has been suggested between tic disorders and streptococcal infections. To understand the complex relationship between streptococcal infections and neuropsychiatric disorders in children the present study was done on colour Doppler echocardiography of patients with possible post-streptococcal tic disorders.
  
  
  METHODS
  The patients were 23 children (22 males, 1 female) affected by tic disorders, who at the time of the observation presented (or had presented in the past) signs of streptococcal infections temporally related to the onset or recrudescence of tic disorders. Echocardiographic examination and laboratory tests were performed on these children.
  
  
  RESULTS
  In 4 cases a mild mitral insufficiency and in 8 cases a minimal mitral insufficiency was seen, all haemodynamically not significant. Follow up studies (up to 1 yr) showed the consistency and persistence of these findings. Of the 12 patients with echocardiographic abnormalities, 10 displayed very high anti streptolysin O (ASO) titres, 5 showed positive cultures for GAS and 9 had abnormal ESR, even if no significant differences were found in respect to patients with tics and normal echocardiography.
  
  
  CONCLUSIONS
  With the caution due to the design of study and to low number of patients, our data seem to indicate that the pathophysiology of GAS-infection related tic disorders is similar to that SC, at least in some cases.
authors.affiliation: Departments of Child Neuropsychiatry, University La Sapienza of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cardona
authors.forename: A
authors.initials: A
authors.lastname: Romano
authors.forename: G
authors.initials: G
authors.lastname: Cundari
authors.forename: F
authors.initials: F
authors.lastname: Ventriglia
authors.forename: P
authors.initials: P
authors.lastname: Versacci
authors.forename: G
authors.initials: G
authors.lastname: Orefici
mesh_terms: D002648:Child; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D008297:Male; D013290:Streptococcal Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D013981:Tic Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000382:microbiology