[Causes of tic disorders in children]. / Przyczyny tików u dzieci hospitalizowanych.

THE AIM OF THE WORK: Tic disorders are differentiated in their symptomatology and time of duration. Assessing the courses of tics can be crucial for more successful treatment. The aim of the study was to identify the egzogenic and endogenic causes of tic disorders. MATERIAL AND METHODS: The group of 20 children and adolescents, 6 girls and 14 boys, aged 4-16 years, with tic disorders were analysed. 8 of them were identified as having transient tics 6 chronic motor or vocal tics and 6 Tourette's syndrome. WISC-R, Terman-Merrill, and Raven, Bender-Koppitz and Benton tests and questionnaire "Who are you", and projection tests, talk to children and their parents were used. RESULTS: The analysed group consisted of 70% boys. Gestational and perinatal risk factors were confirmed in 5 children, in similar percentage of different types of tics. In 20% of patients CT or MRI examination showed mild abnormalities, whereas EEG examination excluded epileptic discharges. Majority of children with tics demonstrated significant emotional sesitivity (70%) and tendency to repress fear and anger (60%). Hyperkinetic disorders co-existing with Tourette's syndrome in 3 patients, while learning disabilities were confirmed in 30% children with tic disorders. The presence of negative environmental factors which may contribute to trigger tics showed a half of children from analysed group. Above all children experienced stress in family (40%) and/or in school (20%). The biological and/or environmental factors were detected in 80% children. They were not established in four patients: in one with transient tics and in three with Tourrete's syndrome. CONCLUSION: The identification of biological and environmental factors is necessary in children with tics, because they are present and significant in majority of children. In 20% of children these factors were not confirmed and in this group other causes should be considered. Considering the risk of disordered emotional and social functioning of children with tics, leading in many cases to tics exacerbation, complex therapeutic care should be provided.

[Psychological evaluation in children with a cavum of the septum pellucidum]. / Wyniki oceny psychologicznej dzieci z torbiela przegrody przezroczystej.

THE AIM OF THE STUDY: Was to determine the influence of the persistent cavum of the septum pellucidum (CSP) on the children intellectual development in different age groups. THE MATERIAL AND METHODS: There were 53 children with CSP examined (3.4% of the hospitalised children), 28 girls and 25 boys aged 2 months-14 years. Among them 30 was with normal intellectual development, 14 children with IQ under the average and 9 with mental retardation. The control group consists of 30 children without CSP and with normal intellectual development. The children were divided into three groups: aged under 2 years, between 2 and 6 years and between 7 and 14 years. Using Psyche Cattell, Terman-Merrill and D. Wechsler (WISC-R) scales performed the general intellectual assessment. The evaluation of the cognitive, motor abilities and lateralization of the motor and visual functions in children was done using tests: Bender-Koppitz, Benton, R. Zazzo, M. Stambak, H. Spionek and Lingual Abilities Test. The anamnesis was obtained from parents. The statistic analyses was performed with chi-square and Fisher tests. RESULTS: The percentage of children with IQ under average and with mental retardation in the group <2 years was 60%, in 2-6 years 47% and in the group 7-14 years was 35%. The study show significantly lower score in the Code test of the D. Wechsler scale in children with CSP and normal intellectual development. Older children presented also significantly lower scores in manual abilities. A lot of intellectual functions were deleted in the majority of the children with CSP and the IQ under the average or with mental retardation. CONCLUSION: The CSP in children is connected to the deficits of the intellectual functions and that why the psychological assessment should be early performed in children with CSP.

[Psychological characteristics of children and adolescents with primary headache]. / Psychologiczna charakterystyka dzieci i mlodziezy z samoistnymi bólami glowy.

THE AIM OF THE WORK: Primary headache involved almost one half of the population in developmental age. This ailment still increased. Authors likes to determined endogenous and environmental factors of resulting headache in children and adolescents. MATERIAL AND METHODS: The group of 78 children and adolescents, 49 girls and 29 boys, aged 6-17 years, with primary headaches were analysed. 28 of them suffered from migraine, 43 from tension headaches and 7 from from of these types of headaches. WISC-R and WAIS-R, Bender-Koppitz and Benton tests and questionaires "who are you", ISCL-STAI and projections, discussion with children and their parents were used. Statistical analysis was done with Fisher, variations and a posteriori Scheffe tests. RESULTS: In almost all patients IQ was normal. 16-18% of children in D. Wechsler subtests showed disturbances of the memory, visual brightness, spatial, visuo-motor organisation. Subtests data were higher in children with migraine. In 22-30% of children with primary headaches intellectual development was disharmonic. In 13-21% of analysed children disturbances were present of the development visuo-motor integretion, visual memory, and specific school abilities. Emotional status in children with headaches was also disturbed. Migraineurs were rarer repressed, negative emotion and were more often self-confident. Majority of children had school problems, which was relevant to discrepancy between the level of aspirations and achievements. Moreover. children with tension headaches had more often real problems with school obligations. Almost one half of the children had family problems. CONCLUSION: Tension-type headache were more frequent in children above 12 years of age. Majority of children and adolescents with primary headache were intellectually normal, but IQ and subtest data were higher in the migrainieurs. Partial cognitive deficits could be risk factors for headache, particulary tension-type headache. Majority of children with primary headache had school problems and almost one half of them had family problems.

[Verbal and drawing expression of primary headaches in developmental age]. / Werbalna i rysunkowa ekspresja samoistnych bólów glowy w wieku rozwojowym.

THE AIM OF THE STUDY: Children and adolescents are the subject, which suffers from primary headaches. Type and character of the pain is known only by them and their relations are necessary to know it. This study was performed to establish how children and adolescents express verbally and by paintings their headaches. MATERIAL AND METHODS: The group of 52 patients with primary headaches and normal IQ was analysed. It was 35 girls and 17 boys, aged 6-17 years. Due to IHS International Classification, 20 of them suffered from migraine, and 32 from tension headaches. All patients were asked by physician to illustrate their headache verbally and by painting. Description should involve details about pain character, its localisation, severity, time of duration, frequency and time of appearance, and also accompaning symptoms. Instruction was to use 1/2 -1 page and to colour paintings. RESULTS: Only 11/52 children illustrated headaches by painting. Red colour dominated on these illustrations. 20% of children only described pain using verbal expression as normal for their age level. Other children used very short elaboration, from laconic to full pain characteristic. CONCLUSION: Patients in developmental age more often used verbal than drawing expression of their headaches. Migraine and tension headaches drawing was significantly different. Also verbal expression of migraine was different in localisation and symptoms during pain and accompanied pain. It is necessary to investigate headaches in a subjective and quantitative way.