title: Trichotillomania, bipolar disorder and white matter hyperintensities in a six-year old girl.
abstract: A six-year-old girl was referred to our child psychiatry outpatient clinic by the Pediatric Neurology Unit with a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) and trichotillomania. She had neither eyebrows nor eyelashes. The clinical picture was of irritability, frequent tantrums, and aggressive behaviour. During the following year she presented several brief episodes of intense mood changes, which typically started with night-time onset trichotillomania and sleep disturbance. The episodes lasted no longer than five days and recurred within one or two months. A diagnosis of pediatric bipolar disorder (BD) was made after the first months of clinical follow-up. An MRI showed focal white matter hyperintensities (WMH) in T2.
authors.affiliation: Child and Adolescent Psychiatry Unit, Department of Psychiatry, Puerta de Hierro Majadahonda Hospital, Madrid, Spain.
authors.forename: Ibone
authors.initials: I
authors.lastname: Olza-Fernández
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Palanca-Maresca
authors.forename: Sara
authors.initials: S
authors.lastname: Jiménez-Fernández
authors.forename: María Rosario
authors.initials: MR
authors.lastname: Cazorla-Calleja