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A Follow-Up Study of Hyperkinetic Children
Published online by Cambridge University Press: 08 February 2018
Extract
In a study on chorea, tics and compulsive utterances, Creak and Guttmann (1) discussed some problems of the inter-relation of organic neurological and neurotic symptoms. They showed that residuals, latent or manifest, of neurological diseases of the motor system may be instrumental in shaping the clinical picture of neuroses. There is generally no difficulty in demonstrating such interrelations, if the neurological anomalies are of a well-known type and clear cut in onset. Pareses, peripheral or central, or aphasic disorders, are generally not difficult to recognize where they are the nucleus of a neurotic picture, and not much objection is encountered if one tries to assess their importance, pathogenetic or pathoplastic, in a given clinical picture. This, however, is difficult where less well known syndromes are concerned, such as apraxic or agnosic pictures, or where beginning or end are gradual and the whole picture less clearly defined, as in disturbances of the extra-pyramidal motor system. To recognize an early stage of Parkinsonianism within a depression or other “neurotic” illness is not easy. The same is true of mild extra-pyramidal hyperkinetic states, partly because they may be so similar to normal movements (pseudo-purposeful), and partly because the milder anomalies as seen in early or later stages (and in abortive cases) are little known.
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- Part I.—Original Articles
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- Copyright © Royal College of Psychiatrists, 1940
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