[Causes of tic disorders in children].
OBJECTIVE
Tic disorders are differentiated in their symptomatology and time of duration. Assessing the courses of tics can be crucial for more successful treatment. The aim of the study was to identify the egzogenic and endogenic causes of tic disorders.


METHODS
The group of 20 children and adolescents, 6 girls and 14 boys, aged 4-16 years, with tic disorders were analysed. 8 of them were identified as having transient tics 6 chronic motor or vocal tics and 6 Tourette's syndrome. WISC-R, Terman-Merrill, and Raven, Bender-Koppitz and Benton tests and questionnaire "Who are you", and projection tests, talk to children and their parents were used.


RESULTS
The analysed group consisted of 70% boys. Gestational and perinatal risk factors were confirmed in 5 children, in similar percentage of different types of tics. In 20% of patients CT or MRI examination showed mild abnormalities, whereas EEG examination excluded epileptic discharges. Majority of children with tics demonstrated significant emotional sesitivity (70%) and tendency to repress fear and anger (60%). Hyperkinetic disorders co-existing with Tourette's syndrome in 3 patients, while learning disabilities were confirmed in 30% children with tic disorders. The presence of negative environmental factors which may contribute to trigger tics showed a half of children from analysed group. Above all children experienced stress in family (40%) and/or in school (20%). The biological and/or environmental factors were detected in 80% children. They were not established in four patients: in one with transient tics and in three with Tourrete's syndrome.


CONCLUSIONS
The identification of biological and environmental factors is necessary in children with tics, because they are present and significant in majority of children. In 20% of children these factors were not confirmed and in this group other causes should be considered. Considering the risk of disordered emotional and social functioning of children with tics, leading in many cases to tics exacerbation, complex therapeutic care should be provided.
Prajsner
Barbara
B
Klinika Chorób Dzieci Katedry Pediatrii, Collegium Medicum, Uniwersytetu Jagiellońskiego, Kraków. neupedkr@cm-uj.krakow.pl
Pilch
Bozena
B
Bałajewicz
Anna
A
Wesołowska
Ewa
E
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004777:Environment; D005260:Female; D006760:Hospitalization; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011386:Projective Techniques; D012649:Self Concept; D012720:Severity of Illness Index; D013981:Tic Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D014057:Tomography, X-Ray Computed