Tourette's syndrome is a disorder of
the central nervous system first described by French neurologist Gilles de la
Tourette for over 100 years. The major clinical manifestation is the occurrence
of tics, ie movements (motor tics) or sounds (vocal tics) sudden, brief,
involuntary or semi-voluntary.
Patients with Tourette's have many motor tics and at least one vocal tic almost every day for over a year. The disease begins in childhood or during adolescence.
Tics are relatively common, occurring most frequently in the age group between 9 and 11 years and affecting up to 10% of children. Rather, Tourette's is much less common, occurring in less than 1% of children. The male is affected with a frequency three times higher than females. The disease is more common in children with autism or Asperger syndrome (diseases in which there is difficulty in social interaction).
Tourette's syndrome has probably multiple causes, appearing to have a strong genetic component, although the genetic mechanisms are not yet known. The probability of a close family member of a person with Tourette's tics present is approximately 25%. In about 90% of cases of disease found in identical twins (monozygotic), the twins are affected. Moreover, environmental factors likely play a role in the development of Tourette syndrome (for example, stress or infection), but these causes are not well defined.
Tourette's Syndrome is often accompanied by other behavioral or emotional problems, such as hyperactivity disorder defective attention, obsessive compulsive disorder, learning difficulties, sleep disturbance, depression or anxiety.
Treatment
The best treatment combines several approaches. The aim is to remove the ticks and to identify and address the problems. Initially you should identify which claims that more incapacitate patients, tics or associated problems, as the primary target of treatment.
Education and Support
The doctor will start by explaining to the patient and their families the natural evolution of the disease. Tics will probably diminish in intensity and frequency as time passes. With proper treatment can prevent the tics affect life at school, work and interpersonal relationships.
The self-help groups can provide support and education. Individual psychotherapy can help patients cope with the social problems and the feelings of embarrassment and low self-esteem. A therapist can also help parents to support the child's efforts to control unwanted behaviors.
You may need similar efforts in the child's school. With the permission of the family, can be provided education and practical support to teachers, other educators and colleagues.
Suppression of tics
The severity of tics can often be reduced with medicines, behavioral therapy, or both.
Behavioral therapy may be used alone or combined with medication. One technique that has proven effective is called reversal training habit. The therapist teaches the patient to use a specific muscle movement or behavior to compete with the tic. Other behavioral techniques are possible positive reinforcement, relaxation training and self-monitoring, in which one learns to know when the tics are more likely to occur.
Drug treatment can not completely eliminate the tic by which the aim is to reduce tics to a manageable level, so that they cause less discomfort and interfere less with the operation of the child.
Doctors usually prescribe medicines with few side effects as, e.g., clonidine. Unfortunately, these drugs are not as effective as second-line drugs, a class of drugs known as antipsychotics, such as sulpiride, and pimozide, and that have more side effects.
The older antipsychotic such as haloperidol, have proved effective when administered in low doses. The side effects include sedation, weight gain, dry mouth, and muscle stiffness. The novel antipsychotics have recently shown to be effective in some patients and, in these cases, side effects can be more easily tolerated. These drugs include risperidone, olanzapine, quetiapine and ziprasidone.
It can also be used another drug, tetrabenazine, but whose possible side effects parkinsonism (tremor) and depression.
Since each patient responds differently to treatment, you may need to try several medications before finding one that is more effective and which makes fewer side effects.
Treatment of other conditions
In case of psychiatric illness associated with, the patient should be evaluated by a specialist. Related diseases are the most common defect hyperactivity disorder Attention and obsessive compulsive disorder. Additionally, patients may need treatment for learning problems and relationship to depression or anxiety.
Prevention
Tourette's Syndrome can not be prevented but their early detection and treatment can reduce the severity of tics and prevent many of the problems of everyday life caused by this disease.
Patients with Tourette's have many motor tics and at least one vocal tic almost every day for over a year. The disease begins in childhood or during adolescence.
Tics are relatively common, occurring most frequently in the age group between 9 and 11 years and affecting up to 10% of children. Rather, Tourette's is much less common, occurring in less than 1% of children. The male is affected with a frequency three times higher than females. The disease is more common in children with autism or Asperger syndrome (diseases in which there is difficulty in social interaction).
Tourette's syndrome has probably multiple causes, appearing to have a strong genetic component, although the genetic mechanisms are not yet known. The probability of a close family member of a person with Tourette's tics present is approximately 25%. In about 90% of cases of disease found in identical twins (monozygotic), the twins are affected. Moreover, environmental factors likely play a role in the development of Tourette syndrome (for example, stress or infection), but these causes are not well defined.
Tourette's Syndrome is often accompanied by other behavioral or emotional problems, such as hyperactivity disorder defective attention, obsessive compulsive disorder, learning difficulties, sleep disturbance, depression or anxiety.
Treatment
The best treatment combines several approaches. The aim is to remove the ticks and to identify and address the problems. Initially you should identify which claims that more incapacitate patients, tics or associated problems, as the primary target of treatment.
Education and Support
The doctor will start by explaining to the patient and their families the natural evolution of the disease. Tics will probably diminish in intensity and frequency as time passes. With proper treatment can prevent the tics affect life at school, work and interpersonal relationships.
The self-help groups can provide support and education. Individual psychotherapy can help patients cope with the social problems and the feelings of embarrassment and low self-esteem. A therapist can also help parents to support the child's efforts to control unwanted behaviors.
You may need similar efforts in the child's school. With the permission of the family, can be provided education and practical support to teachers, other educators and colleagues.
Suppression of tics
The severity of tics can often be reduced with medicines, behavioral therapy, or both.
Behavioral therapy may be used alone or combined with medication. One technique that has proven effective is called reversal training habit. The therapist teaches the patient to use a specific muscle movement or behavior to compete with the tic. Other behavioral techniques are possible positive reinforcement, relaxation training and self-monitoring, in which one learns to know when the tics are more likely to occur.
Drug treatment can not completely eliminate the tic by which the aim is to reduce tics to a manageable level, so that they cause less discomfort and interfere less with the operation of the child.
Doctors usually prescribe medicines with few side effects as, e.g., clonidine. Unfortunately, these drugs are not as effective as second-line drugs, a class of drugs known as antipsychotics, such as sulpiride, and pimozide, and that have more side effects.
The older antipsychotic such as haloperidol, have proved effective when administered in low doses. The side effects include sedation, weight gain, dry mouth, and muscle stiffness. The novel antipsychotics have recently shown to be effective in some patients and, in these cases, side effects can be more easily tolerated. These drugs include risperidone, olanzapine, quetiapine and ziprasidone.
It can also be used another drug, tetrabenazine, but whose possible side effects parkinsonism (tremor) and depression.
Since each patient responds differently to treatment, you may need to try several medications before finding one that is more effective and which makes fewer side effects.
Treatment of other conditions
In case of psychiatric illness associated with, the patient should be evaluated by a specialist. Related diseases are the most common defect hyperactivity disorder Attention and obsessive compulsive disorder. Additionally, patients may need treatment for learning problems and relationship to depression or anxiety.
Prevention
Tourette's Syndrome can not be prevented but their early detection and treatment can reduce the severity of tics and prevent many of the problems of everyday life caused by this disease.
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