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神经发育运动障碍——儿童运动刻板行为的最新进展

Neurodevelopmental movement disorders - an update on childhood motor stereotypies.

机构信息

King's College London School of Medicine, London.

出版信息

Dev Med Child Neurol. 2011 Nov;53(11):979-85. doi: 10.1111/j.1469-8749.2011.04058.x. Epub 2011 Jul 12.

Abstract

AIM

The term 'stereotypies' encompasses a diverse range of movements, behaviours, and/or vocalizations that are repetitive, lack clear function, and sometimes appear to have a negative impact upon an individual's life. This review aims to describe motor stereotypies.

METHOD

This study reviewed the current literature on the nature, aetiology, and treatment of motor stereotypies.

RESULTS

Motor stereotypies occur commonly but not exclusively in autistic spectrum disorders. Similar movements are also found in otherwise healthy children and those suffering sensory impairment, social isolation, or severe intellectual disabilities; they may be persistent over time. Although often difficult, it is possible to define and differentiate stereotypies from other movement disorders such as tics through features of the history, such as earlier onset and examination, together with the presence or absence of associated neurological impairment or developmental difficulties. Co-occurrence with other disorders affecting frontostriatal brain systems, including attention-deficit-hyperactivity disorder, obsessive-compulsive disorder, and tic disorders, is common.

INTERPRETATION

The underlying function of motor stereotypies remains unclear but may include the maintenance of arousal levels. A neurogenetic aetiology is proposed but requires further study. When treatment is sought, there are both pharmacological and behavioural options. Behavioural treatments for motor stereotypies may in time be shown to be most effective; however, they are difficult to implement in children younger than 7 years old.

摘要

目的

“刻板行为”一词涵盖了一系列不同的运动、行为和/或发声,这些行为重复出现,缺乏明确的功能,有时似乎对个人的生活产生负面影响。本综述旨在描述运动性刻板行为。

方法

本研究回顾了关于运动性刻板行为的性质、病因和治疗的现有文献。

结果

运动性刻板行为常见,但并非仅见于自闭症谱系障碍。在其他健康儿童以及患有感觉障碍、社交隔离或严重智力残疾的儿童中也发现了类似的动作;它们可能会随着时间的推移而持续存在。虽然通常很难,但通过病史的特征,如发病较早和检查,以及是否存在相关的神经损伤或发育困难,可以将刻板行为与其他运动障碍(如抽搐)进行定义和区分。共病影响额纹状体脑系统的其他疾病,包括注意缺陷多动障碍、强迫症和抽动障碍,很常见。

解释

运动性刻板行为的潜在功能仍不清楚,但可能包括维持唤醒水平。提出了神经发生病因学,但需要进一步研究。当寻求治疗时,有药物和行为选择。运动性刻板行为的行为治疗可能最终被证明是最有效的;然而,对于 7 岁以下的儿童来说,它们很难实施。

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