Çocuk ve ergenlerde tik bozuklukları: Klinik ve etiyolojik bir bakış

Normal davranışı andıran, ani ve tekrarlayıcı hareket, jest ve seslerden oluşan tikler, gelip geçici tik bozukluğundan psikososyal gelişimde, benlik saygısında, aile yaşantısında, sosyal ilişkilerde, akademik veya iş performansında bozulmaya kadar uzanan geniş bir yelpaze oluşturmaktadır. Basit-geçici tikler tüm çocukların %6-20sinde görülebilirken, Tourette Sendromu (TS) prevalansı çocuklarda 56/1000dir. Çocuk ve ergenlerde bu denli sık izlenen tikler, şiddet, yoğunluk ve sıklık açısından artıp azalan bir seyir izler. Genellikle yaşamın ikinci dekadının başlarında pik yapar; birçok hastada ergenliğin sonlarında tik şiddetinde belirgin bir azalma olur. Psikososyal stresörler, genetik, epigenetik faktörler ve bu faktörlerin birbiriyle etkileşimleri tik bozukluklarının etiyolojisinden sorumlu tutulmuştur. Son yıllarda genetik ve çevresel risk faktörlerinin etkileşimini araştırmak açısından TSnin çok uygun bir model oluşturduğu fark edilerek, bu konudaki araştırmalarda büyük ivme kazanılmıştır.

Tic disorders in children and adolescents: A clinical and etiological view

Tic disorders which involve sudden and repetitive movements, gestures, or vocalizations form a spectrum ranging from simple transient tic disorders to more severe tic disorders that may cause significant impairment in psychosocial development, self esteem, family and social relationships, or academic/career performance. Around 6-20% of children experience simple transient tic disorder, while the prevalence of Tourette Syndrome (TS), a more severe tic disorder, is 5 to 6 cases in 1000 children. The severity and frequency of tics may change over time: usually peaking at the beginning of the second decade of life and diminishing towards the end of puberty. Psychosocial stressors, genetic and epigenetic factors and the interactions between these factors are involved in the etiology of tic disorders. In recent years, with the understanding of the suitability of TS as a model in investigating the interaction between genetic and environmental risk factors, increasing number of researches have been conducted in that direction.

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