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Published on: November 21, 2013
Cognitive and psychiatric phenotypes of movement disorders in children: a systematic review
Hilla Ben-Pazi1, Solomon Jaworowski, Ruth S Shalev
1Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel. benpazi@gmail.com
Insights
Recognizing cognitive and psychiatric symptoms in pediatric movement disorders is crucial for effective management. This review highlights key non-motor phenotypes in various childhood movement disorders to guide diagnosis and treatment.
Area of Science:
- Pediatric Neurology
- Neuropsychiatry
- Movement Disorders
Background:
- Cognitive and psychiatric aspects of adult movement disorders are known, but pediatric profiles are less defined.
- Understanding non-motor phenotypes in children is essential for guiding treatment and differentiating disorder-specific symptoms from medication effects.
Purpose of the Study:
- To outline known cognitive and psychiatric symptoms associated with pediatric movement disorders.
- To summarize non-motor phenotypes to aid in the diagnosis and management of childhood movement disorders.
Main Methods:
- Systematic review of PubMed literature.
- Over 400 abstracts were reviewed, with 88 papers reporting pediatric non-motor symptoms summarized.
Main Results:
- Obsessive-compulsive disorder noted in pediatric autoimmune neuropsychiatric disorders and Sydenham chorea.
- Attention-deficit-hyperactivity disorder is a comorbidity in Tourette syndrome, stereotypies, and restless legs syndrome.
- Depression, anxiety, affective disorders, and cognitive decline were associated with specific pediatric movement disorders like idiopathic dystonia, Wilson disease, and juvenile Huntington disease.
Conclusions:
- Emerging literature on non-motor phenomena in pediatric movement disorders.
- Recognizing salient cognitive and psychiatric symptoms can facilitate better management of these conditions.
Aim:
The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication effects.
Method:
The goal of this review is to outline the known cognitive and psychiatric symptoms associated with paediatric movement disorders. We used a systematic approach, via PubMed, and reviewed over 400 abstracts of studies of selected disorders, of which 88 papers reporting paediatric non-motor symptoms are summarized.
Results:
Obsessive-compulsive disorder was manifest in children with paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and Sydenham chorea. Children with opsoclonus-myoclonus syndrome had, for the most part, cognitive and behavioural problems, and attention-deficit-hyperactivity disorder was reported as a major comorbidity in Tourette syndrome, stereotypies, and restless legs syndrome. Symptoms of depression and anxiety were more frequent in individuals with idiopathic dystonia. Affective disorders were suggestive of Wilson disease. Cognitive decline was common in children with juvenile Huntington disease. A limitation of this review was the lack of systematic assessment in paediatric movement disorders for evaluation and uniform definitions.
Interpretation:
Although the literature in non-motor phenomena is still emerging, recognition of salient cognitive and psychiatric phenomena may facilitate management of paediatric movement disorders.
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