Download Tourette*s syndrome

WHAT IS TOURETTE’S SYNDROME
Neurological disorder
Involving uncontrolled movements or sounds known as
tics
Scientists believe that tics may result from changes in brain
chemicals (neurotransmitters) that are responsible for producing
and controlling voluntary movements.
WHAT ARE TICS
Motor and Vocal Tics
• Simple motor tics
• Clonic tics : sudden muscle or limb jerks, like a spasm.
• Tonic tics : tensing of the muscles
• Dystonic : twisting pulling or squeezing movements resulting
in a briefly maintained abnormal posture
• Simple vocal tics are wordless sounds
WHAT ARE TICS CONT’D
•
Complex Motor tics
• Involves slower, longer, and more purposeful movements
•
Complex Vocal tics
• Include uttering syllables, words, phrases,
• Palilalia: repeating one’s self
• Echolalia: repeating others
• Coprolalia: uttering of socially inappropriate language, swearing
•
Common motor tics seen in
Tourette syndrome
Common vocal tics seen in Tourette
syndrome
Simple tics
Complex tics
Simple tics
Complex tics
Eye blinking
Touching the
nose
Hiccupping
Using different
tones of voice
Head jerking
Touching other
people
Yelling
Repeating one's
own words or
phrases
Shoulder
shrugging
Smelling
objects
Throat clearing
Repeating others'
words or phrases
Eye darting
Obscene
gesturing
Barking
Using vulgar,
obscene or swear
words
Finger flexing
Flapping the
arms
DSM-IV
• have two or more motor tics
• have had tics for at least a year. The tics
can occur many times a day (usually in
bouts) nearly every day, or off and on.
• have tics that begin before he or she is 18
years of age.
• have symptoms that are not due to taking
medicine or other drugs or due to having
another medical condition (for example,
seizures, Huntington disease, or postviral
encephalitis).
SOME STATISTICS
• It is not known exactly how many people have Tourette Syndrome
(TS). Some studies have found that 1 of every 360 children between 6
and 17. Other studies using different methods have estimated the rate
of TS at 1-10 per 1000 children.
• 27% have been reported as having moderate or severe forms of the
condition.
• TS affects people of all racial and ethnic groups.
• Boys are affected three to five times more often than girls.
• A TS diagnosis is twice as likely among non-Hispanic White people
than among Hispanic and non-Hispanic Black people.
• A diagnosis of TS is twice as common among children 12 through 17
years of age as among those 6 through 11 years of age.
CO-MORBID CONDITIONS
• Attention-deficit/hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• Learning disabilities
• Sleep disorders
• Depression
MEDICAL TREATMENT
•
Drugs that block or deplete the
neurotransmitter dopamine in the brain:
Used to control tics. Side effects: weight
gain and a dulling of the mind.
(fluphenazine, Haldol)
•
Botulinum toxin type A (Botox) injections.:
For simple or vocal tics, an injection into the
affected muscle may help relieve the tic.
•
Stimulant medications: Used to help
increase attention and concentration for
people with ADHD. (methylphenidate
(Concerta, Ritalin, others)
(dextroamphetamine (Adderall XR,
Dexedrine, others).
MEDICAL TREATMENT CONT’D
Central adrenergic inhibitors:. Typically
prescribed for high blood pressure, these
drugs may help control behavioral
symptoms, such as impulse control
problems and rage attacks. Side effects
may include sleepiness.
• Antidepressants:. These may help
control symptoms of sadness, anxiety
and OCD. (clonidine (Catapres) or
guanfacine (Tenex) fluoxetine (Prozac,
Sarafem, others)
•
THERAPY TREATMENT
• Psychotherapy.: May help individual cope
with Tourette syndrome, may help with
additional conditions ADHD, obsessions,
depression or anxiety.
• Behavior therapy: Habit Reversal
Training: monitor tics and identify
premonitory urges —respond to urges
voluntarily; move incompatibly with the
tic, hopefully suppressing the tic.
IMPACT
Individual with Tourette’s
Syndrome may
experience difficulties with:
problems concentrating in class
Homework
Examinations,
Writing,
Anxiety
Depression
Shame teasing and bullying by
other students
Unhelpful responses by school staff
Irritability
Antisocial behavior
Self-harming behavior (less
commonly)
Inappropriate behavior to others
REFERENCES
•
Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/cerebral-palsy/basics/definition/con20030502
•
Movement Disorder Society
http://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Tics-Tourette-Syndrome.htm
•
Tourette Canada
http://www.tourette.ca
•
CDC
http://www.cdc.gov/ncbddd/tourette/data.html
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm
•
Web MD
http://www.webmd.com/brain/tourettes-syndrome?page=2