3 CASES OF SYMPTOM CHANGE IN TOURETTES-SYNDROME AND OBSESSIVE-COMPULSIVE DISORDER ASSOCIATED WITH PEDIATRIC CEREBRAL MALIGNANCIES

Objective-To correlate behaviour manifestations with tumour location i n three children who had Gilles de la Tourette's syndrome (GTS), obses sive - compulsive disorder (OCD), and primary cerebral malignancies. M ethod-Cases were ascertained from a chart review in a GTS and OCD spec ialty clinic. For each case the temporal progression of change in neur opsychiatric symptoms was qualitatively correlated with radiographic d ocumentation of tumour progression. Results-The change in symptom seve rities during tumour progression and treatment, together with prior ne urobiological studies of GTS, suggest that the ventral striatum, corpu s callosum, thalamus, and midbrain are potentially important neural su bstrates in the formation or modulation of tic symptoms. The limbic sy stem, including the hypothalamus and cingulate, and the caudate nucleu s, seem to be important in the neurobiology of OCD. All structures are neuroanatomically and functionally related to the corticostriato-thal amocortical circuitry that is thought to subserve symptom generation i n both GTS and OCD. Conclusion-Although the malignancies were not Like ly to have caused the tic and OCD symptoms in these children, the loca tions of these intracranial lesions provide important clues in identif ying brain regions that may contribute to the determination of tic and OCD severities.