פנוטיפים שכליים ופסיכיאטריים בהפרעות תנועה בילדים
COGNITIVE AND PSYCHIATRIC PHENOTYPES OF MOVEMENT DISORDERS IN CHILDREN
Movement disorders resulting from treatment
בהפרעות תנועה בילדים
הלה בן-פזי, סולמון יברובסקי, רות שלו
Hilla Ben-Pazi1, Solomon Jaworowski1,2, Ruth S. Shalev MD1
1Neuropediatric Unit and 2Department of Psychiatry, Shaare Zedek Medical Center, Jerusalem, Israel
Background: Cognitive and psychiatric aspects of adult movement disorders are well established, yet for pediatric movement disorders specific behavioral profiles have not been delineated. Knowledge of specific psychiatric phenotypes may assist in establishing diagnosis, increasing treatment awareness and determining which symptoms are suggestive of specific movement disorder and which are altered or induced by medication.
Materials & Method: The goal of this review is to outline the extant of known non-motor symptoms associated with pediatric movement disorders. We reviewed over 300 abstracts of selected pediatric movement disorders of which 84 reported cognitive and psychiatric symptoms.
Results: Obsessive compulsive disorder was manifest in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) and Sydenham's chorea. Children with opsoclonus myoclonus syndrome had, for the most part, cognitive and behavioral problems and ADHD was reported as a major comorbidity in Tourette syndrome, sterotypies and restless legs syndrome. Symptoms of depression and anxiety were more frequent in idiopathic dystonia and torsion dystonia (DYT1). Affective disorders were suggestive of Wilson's disease. Cognitive decline was common in Juvenile Huntington's disease.
Conclusion: Although the literature in non-motor phenomena is still emerging, recognition of salient cognitive and psychiatric phenomena may facilitate diagnosis and management of pediatric movement disorders.