Enfermedad de los tics (síndrome de Gilles de la Tourette): características clínicas de 70 pacientes

Background: Tourette’s syndrome is a childhood-onset hereditary neurobehavioural disorder believed to occur without geographical restrictions. Although there have been reports of this disorder worldwide just a few are from Latin America. Aim: To report a preliminary experience with a series of 70 pa...

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Autores principales: Miranda C,Marcelo, Menéndez G,Pedro, David G,Perla, Troncoso Sch,Mónica, Hernández Ch,Marta, Chaná C,Pedro
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 1999
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98871999001200010
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Sumario:Background: Tourette’s syndrome is a childhood-onset hereditary neurobehavioural disorder believed to occur without geographical restrictions. Although there have been reports of this disorder worldwide just a few are from Latin America. Aim: To report a preliminary experience with a series of 70 patients and to review recent advances in this disorder. Patients and Method: We reviewed patients seen in pediatric and adult neurological clinics in Santiago, Chile, all of whom fulfilled clinical diagnostic criteria for Tourette Syndrome. Results: Seventy patients were studied, 54 males (77.1%) and 16 females (22.8%), their mean age at first evaluation was 13.6 years (range 2-46). The mean age of onset of symptoms was 6.4 (range 2-20), the mean time of follow-up was 3 years. Fifty-eight patients showed simple motor tics (blinking, facial grimacing, shoulder shrugging), whereas dystonic tics like head jerking were seen in 38 patients, torticollis in 6 and oculogyric movements in 2. Complex motor tics like jumping, antics, trunk bending and head shaking were present in 16 subjects. Vocal tics were predominantly of the simple type: sniffing, throat clearing, blowing, and whistling. Complex vocal tics were seen in 12 patients, five cases showed palilalia, 3 echolalia and only six displayed coprolalia (8.5%). Tics were of mild to moderate severity in most patients. Obsessive-compulsive disorder was observed in 22.8% and attention deficit and hyperactivity disorder were present in 35.7%. Forty-five patients (64.2%) had a first degree relative with tics, nine patients (12.8%) had a family history of obsessive-compulsive disorder. The current evidence involving desinhibition of cortico-striatum-thalamic-cortical neuronal circuits in the pathogenesis of this disorder is analyzed. Conclusion: Our report supports the recognized clinical homogeneity and genetical basis of Tourette’s syndrome regardless of geographical region and ethnic origin.