Meu filho tem tique de piscar os olhos: e agora?

Muitos pais trazem seus filhos para consulta quando observam tiques de piscar os olhos em seus filhos. A maioria vai primeiro ao oculista, ao alergologista, ao neurologista e por fim ao psiquiatra. O artigo abaixo relata um estudo que foi feito com crianças de 8 anos em acompanhamento por alguns anos (média de 6 anos) e que de início apresentavam tiques de olhos: piscar, rodar e abrir os olhos forçadamente e não tinham um diagnóstico de Tourette ou TOC. Das 32 crianças que foram reavaliadas, 10, ou seja, 1/3, preenchia critérios para ST. Ou seja, embora este seja um estudo pequeno, mostra que há 33% de chance de que tiques nos olhos possam ser o início de um quadro de Tourette.         

J AAPOS. 2014 Feb;18(1):31-5. doi: 10.1016/j.jaapos.2013.11.007.

The long-term outcomes of ocular tics in a pediatric neuro-ophthalmology practice.

Bisker ER1, McClelland CM2, Brown LW3, Liu GT4.

Abstract

PURPOSE:

To describe the outcome and comorbidities of ocular tics in children evaluated by a pediatric neuro-ophthalmologist.

METHODS:

The medical records of all consecutive patients in a pediatric neuro-ophthalmology practice diagnosed with ocular tics (eye rolling, blinking, and widening) were retrospectively reviewed. Children with known secondary causes for tics were excluded. Patients, parents, and/or guardians were contacted by telephone to obtain follow-up information.

RESULTS:

A total of 43 patients were included in the retrospective cohort, with a mean age of 7.8 ± 4.8 years at diagnosis. Thirty-two patients participated in the follow-up survey, with an average follow-up of 6.1 ± 3.9 years. None of the 43 children carried a diagnosis of Tourette syndrome or obsessive-compulsive disorder (OCD) at presentation; 1 child had attention deficit hyperactivity disorder (ADHD). At follow-up, 14 of the 32 children (44%) had persistent ocular tics, 3 (9%) reported new nonocular motor tics, 5 (16%) reported new vocal tics, and 4 (13%) developed both nonocular motor and vocal tics. One patient (3%) was formally diagnosed with Tourette syndrome during the follow-up interval, and 3 (9%) were diagnosed with ADHD.

CONCLUSIONS:

Almost half of the children with ocular tics at presentation had persistent ocular tics on follow-up. New nonocular motor and vocal tics occurred in several patients.