DIAGNOSTIC AND TREATMENT DIFFICULTIES IN TICS DISORDER

Objectives: The aim of the study was to analyse the clinical symptoms of tics disorder (including the Tourette syndrome) in children, and verify the diagnosis and assess the methods of treatment. Methods: The analysis was conducted on a group of 51 patients at the age of 11.2±3.2 years, admitted to the Chair and Department of Developmental Neurology to diagnose and treatment of tic disorder. The researchers analysed the symptomatology of tics disorder and the methods of treatment and verified the made diagnoses using the diagnostic criteria according to DSM-IV. Results: Variable tics symptomatology was observed in 22 patients (43.2%). Simple motor tics occurred in 49 patients (98.0%), complex motor tics in 6 cases (11.8%), and vocal tics in 26 cases (51.0%). The dominant symptoms of simple motor tics included: blinking in 28 patients (54.9%) and head movements in 26 children (51.0%). The vocal tics manifesting throat cleaning was observed in 15 patients (29.4%). The co-existence of tics disorder with ADHD symptoms was observed in 13 (25.5%) children. The obsessive – compulsive disorders occurred in 3 patients (5.9%). Only two children (3.9%) were directed to hospital with the suspicion of the Tourette's syndrome, while the diagnostic criteria according to DSM-IV were met by 22 (43.1%). Fifteen patients (29.4%) did not require pharmacological treatment. Other children were most frequently treated with haloperidol (20 patients –55.6%). Clonidine was used in 4 cases (11.1%). Conclusion: The Tourette's syndrome is still too seldom recognised as the reason of tics in children, despite the patients meeting the diagnostic criteria. The pharmacological treatment of tics is dominated by typical neuroleptics, attention should be brought by relatively seldom use of clonidine.