Tourette syndrome and How Do We control It
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Date
2020-03-12
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faculty of Basic Medical Science - Libyan International Medical University
Abstract
Tourette syndrome (TS) is a childhood onset neurodevelopment condition
characterized by multiple motor tics and at least one phonic tic that have persisted for
more than one year since their onset .commonly associated with other co-morbid
conditions – such as Obsessive-Compulsive Disorder (OCD), Attention-Deficit and
Hyperactivity Disorder (ADHD). Its pathophysiology most likely involves basal
ganglia and frontocortical circuits.
TS suppression is common in physicians' offices, and the best time to look for tics is
when the patient is walking into or out of the examination room and theres a criteria
for it that will be discussed later on for its diagnosis.
As for its treatment it includes pharmacological therapy, local intramuscular injection
of botulinum toxin is one of the therapeutic options and surgical treatment with deepbrain stimulation has recently been used in patients with TS who have disabling tics
that are refractory to medication.
Description
Tourette syndrome (TS) is a childhood onset neurodevelopment condition
characterized by multiple motor tics and at least one phonic tic that have persisted for
more than one year since their onset(1) . Tics are defined as paroxysmal , rapid, nonrhythmic movements motor tics or vocalisation phonic tics(2). Motor tics range from
single, short, sudden movements, such as eye blinking or nose twitching to complex
behavioral sequences such as squatting, jumping, or even obscene gestures
(copropraxia) Vocal tics can range from inarticulate single vocalizations to echolalia ,
one repeats the words of other paralilia , one repeats his/her own words or even the
controversial feature of coprolalia “the utterance of obscenities(3).
TS is commonly associated with other co-morbid conditions – such as ObsessiveCompulsive Disorder (OCD), Attention-Deficit and Hyperactivity Disorder (ADHD),
anxiety and affective disorder – in approximately 90% of people with TS, also
document that these co-occurring conditions might affect and diminish the quality of
life of individuals with TS more than the actual tics(4). The cause of Tourette’s
syndrome is unknown, but the pathophysiology most likely involves basal ganglia and
Frontocortical circuits a useful scheme of basal ganglia dysfunction(5).
A mutation in histidine decarboxylase (Hdc), the key enzyme for the biosynthesis of
histamine (HA), has been implicated as a rare genetic cause (6).
This report aims to to broaden your knowledge about what this syndrome is in a
whole, how to diagnose it and how it is managed. Also how patients reacted to
different medications during numerous trials and what type of treatment turned out to
be the most therapeutic.
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