Sell-Salazar F
Servicio de Neuropediatría, Hospital Nacional de Niños, San José, Costa Rica.
Rev Neurol. 2003;37(4):353-8.
Attention deficit/hyperactivity disorder (ADHD) is an early onset childhood condition that is estimated to occur in 7-10 % of school age children.
There are two specific syndromes: a) Attention deficit disorder, without hyperactivity; b) A more complex syndrome, with hyperactivity, with traits of impulsivity, accompanied by attention deficit disorder. The etiology of this syndrome is still unclear, but there have been some hypothesis about hypoperfused areas in the frontal lobe, in some patients where PET has been available. There have been also some response to stimulants; which leads to the conclusion that there is some relation with neurotransmitters like noradrenaline and dopamine, as a determinant factor in the origin of this process. Among 80% of children with this diagnosis, respond positively to the use of psychostimulants. Although, there are some cases that respond poorly, which are evaluated in this review.
This article also highlights the importance of multidisciplinary assessment, in the diagnosis and treatment of these cases. It gives a clinical characterization of the syndrome, following DSM IV guidelines. Finally, it addresses, the use of non stimulant drugs, that can be helpful in the treatment of this disorder.
注意力缺陷多动障碍（ADHD）是一种儿童早期发病的病症，据估计在7%至10%的学龄儿童中出现。
有两种特定综合征：a）注意力缺陷障碍，无多动症状；b）一种更复杂的综合征，伴有多动、冲动特质，并伴有注意力缺陷障碍。该综合征的病因仍不清楚，但对于一些可进行正电子发射断层扫描（PET）的患者，已有关于额叶灌注不足区域的一些假说。对兴奋剂也有一些反应；这导致得出结论，即与去甲肾上腺素和多巴胺等神经递质存在某种关联，作为该过程起源的决定因素。在80%被诊断为此病的儿童中，对使用精神兴奋剂有积极反应。不过，也有一些病例反应不佳，本文对此进行了评估。
本文还强调了多学科评估在这些病例诊断和治疗中的重要性。它按照《精神疾病诊断与统计手册》第四版（DSM IV）指南对该综合征进行了临床特征描述。最后，探讨了可有助于治疗该病症的非兴奋剂药物的使用。
