Mahone E Mark, Bridges Dana, Prahme Cristine, Singer Harvey S
Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Avenue, Baltimore, MD 21231, USA.
J Pediatr. 2004 Sep;145(3):391-5. doi: 10.1016/j.jpeds.2004.06.014.
To characterize clinical features, associated problems, and outcomes for children with complex motor stereotypies who do not have mental retardation or pervasive developmental disorders.
We performed a record review for 40 children (63% male) aged 9 months to 17 years with complex motor stereotypies between 1993 and 2003.
Age at onset was at or before 3 years in 90% of the sample. Symptoms occurred at least once daily in 90%. Excitement was identified as a trigger in 70%. Movements stopped when cued in 98%, and none had stereotypies during sleep. A total of 25% had comorbid attention deficit hyperactivity disorder (ADHD), and 20% had a learning disability. Family history of stereotypies was identified in 25%, tics in 33%, ADHD in 10%, and mood-anxiety disorder in 38%. Pharmacotherapy to target associated conditions was used in 40%, and behavioral therapy was used in 23%. A total of 53% identified symptoms for more than 5 years. Movements resolved in 5% of the children, improved in 33%, were unchanged in 50%, and worsened in 13%.
The clinical course of complex motor stereotypies appears chronic. Better understanding of the clinical features of complex stereotypies in primary care settings is essential for early diagnosis and management.
描述无智力障碍或广泛性发育障碍的复杂运动刻板症儿童的临床特征、相关问题及预后。
我们对1993年至2003年间40名年龄在9个月至17岁之间患有复杂运动刻板症的儿童（63%为男性）进行了病历回顾。
90%的样本起病年龄在3岁及3岁以前。90%的患儿症状每天至少出现一次。70%的患儿兴奋被确定为触发因素。98%的患儿在得到提示后动作停止，且无一例在睡眠中有刻板动作。共有25%的患儿合并注意力缺陷多动障碍（ADHD），20%的患儿有学习障碍。25%的患儿有刻板症家族史，33%有抽动症家族史，10%有ADHD家族史，38%有情绪焦虑障碍家族史。40%的患儿使用针对相关病症的药物治疗，23%的患儿使用行为治疗。共有53%的患儿症状持续超过5年。5%的患儿动作消失，33%有所改善，50%无变化，13%病情加重。
复杂运动刻板症的临床病程似乎呈慢性。在基层医疗环境中更好地了解复杂刻板症患者的临床特征对早期诊断和管理至关重要。
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