[A pediatric cohort with Gilles de la Tourette syndrome]

Andes Pediatr. 2021 Dec;92(6):838-846. doi: 10.32641/andespediatr.v92i6.3304. Epub 2021 Nov 30.
[Article in Spanish]

Abstract

Introduction: Tourette Syndrome (TS) is a common disorder with chronic motor and phonic tics, associated with neuropsychiatric comorbidities.

Objective: To characterize clinical-demographic variables, comor bidities, and management in a pediatric cohort with TS and compare them according to sex.

Patients and method: A retrospective cohort of patients < 18 years old with TS followed up between 2000 and 2018 was evaluated. Clinical records were reviewed obtaining variables of age, sex, reason for consul tation, age of onset, type and complexity of tics, follow-up time, family history, obsessive behaviors, neuropsychiatric and psychopathological comorbidity, neurological disorders, and pediatric mor bidity. Studies and treatments performed, and management used were also recorded.

Results: 126 patients were included, aged between 4-18 years, 103 males (sex F:M ratio = 4.5:1), with a follow-up of 4.8 ± 1.9 years. The mean age of tic onset and TS diagnosis was 6.5 ± 2.2 and 9.4 ± 2.7 years, res pectively, and a diagnostic latency of 2.8 ± 2.2 years. The first consultation in the total of girls was due to tics, in contrast to the boys of whom 14.6% (n = 15) consulted due to comorbidities. There was 38.9% of tics and 8,7% of TS. Neuropsychiatric comorbidities were frequent, recorded in 69.8%, with Attention Deficit Disorder (43.6%) and Obsessive-Compulsive Disorder (20.6%) standing out.110 cases (87.3%), received pharmacological therapy and 54.4% required three or more drugs at some point in their evolution. Only in 16 cases (12.7%), no pharmacological therapy was required, only psychoeducation in 7 (5.6%) cases, and behavioral therapy in 9 cases (7.1%).

Conclusions: The cli nical characteristics of our children with TS are similar to international descriptions, highlighting that in the group of boys, the first consultation could be due to comorbidity, recognizing later the presence of tics. Although psychoeducation and behavioral therapies are recommended as first-line management, most of the patients in this group required pharmacological therapy.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder* / complications
  • Obsessive-Compulsive Disorder* / epidemiology
  • Obsessive-Compulsive Disorder* / therapy
  • Retrospective Studies
  • Tic Disorders* / complications
  • Tic Disorders* / drug therapy
  • Tics* / epidemiology
  • Tics* / etiology
  • Tics* / therapy
  • Tourette Syndrome* / complications
  • Tourette Syndrome* / diagnosis
  • Tourette Syndrome* / epidemiology