Tourette's Syndrome - Causes, Symptoms and Treatment .MF .
Tourette syndrome is a neurological disorder with a genetic predisposition, which manifests itself in early childhood or adolescence to 18 years.Tourette's syndrome is defined by the presence of multiple motor tics and one mechanical or vocal tic, the duration of which should be more than a year.The first symptoms usually are involuntary movements (tick) the face, arms, legs or trunk.These tics are frequent, repetitive and rapid.The most common symptom is a facial tic (eye blink, nose trembling, grimace), and there may be other additional ticks neck, trunk and extremities.
first case of Tourette's syndrome was recorded in 1825 by Dr. Itard.He described the pathology similar to the syndrome have a fairly well-known of the Marquis de Dampierre - French courtier who remember the world the presence of multiple motor and vocal tics.In 1885, French neurologist Georges Gilles de la Tourette, on the instructions of his teacher, the famous French neurologist Charcot saw in his hospital nine patients with simila
Among patients with the syndrome is much more common mental disorders: schizophrenia, obsessive-compulsive disorder, panic attacks.
sndroma Causes of Tourette Syndrome Tourette
- a polygenic disorder to mild syndrome, a combination of twenty genes.If the combination of genes is increased, the disease can be complicated.These individual family studies suggest that Tourette's syndrome - a hereditary disease with suspected autosomal recessive mode of inheritance.More recent studies have suggested an autosomal dominant mode of inheritance (autosomal dominant disease in which inherited only one copy of the defective gene from one parent).Studies in different racial and territorial populations suggest that the mechanism of inheritance is much more complex than previously thought.
symptoms of Tourette's syndrome
main manifestation of the disease - a tick.Tics are involuntary (outside the patient's control), rapid, repetitive and stereotyped (the same) movements of individual muscle groups.A variety of symptoms can be divided into motor, vocal and behavioral.
Motor tics occur suddenly, quickly and pointless.They can be uncomfortable or even painful for the patient.They are easily distinguished from a simple muscle twitches, such as the eyelids or lips.The motor tic can manifest itself in the form of various movements that can make a person: jumps, claps his hands, the tension of the hands or neck muscles, involuntary touching people or objects, obscene gestures.At some point in the complex motor tics character can acquire a ritual character.The patient begins to do, and then repeat or cancel the ones the same steps a number of times (for example, hand to pull ten times before you start to write anything).These complications of symptoms accompanied by considerable internal discomfort of the patient.Motor tics largely worsen the conditions of work or study human.
Engine tick in a patient with Tourette syndrome
Vocal tics more extensive in its structure than the motor.Patients begin to play linguistically meaningless sounds or noises such as hissing, cough or barking.Vocal symptoms may interfere with the smooth flow of speech and remind stuttering or other defects.Often, but not always, vocal symptoms arise at the points of transition of the language, for example, in the beginning of the sentence, where it may be within the meaning of the main part, or at the beginning of words or phrases.Patients may suddenly change the volume of voice information, omit the required phrase or do accents on words or phrases.
greatest social concern is the vocal symptom - eschrolalia, explosive utterance of profanity or more complex sexual, aggressive or derogatory remarks.This is not just expressed in the words of anger or resentment, it is a sudden rush of speech uninterpreted.As a rule, patients voiced only the first syllable, inappropriate words, and then there is the rest of the information you would like to announce the person.While eschrolalia occurs only in a small number of patients from 5 - 30%, it remains the best known of all the symptoms of Tourette's syndrome.
Some patients with the syndrome tend to unconsciously imitate what they have just seen, heard or said.These phenomena are called echopraxia, echolalia and palilalia.For example, the patient may feel the impulse to imitate the movements of the human body, with which he talks, or try to reproduce the speech of the speaker.Some patients describe the appearance of their "triggers", the so-called signs that suggest them about the beginning of teak, such as another person's cough.
Tourette Syndrome Diagnosis
Tourette's Syndrome is put, if the doctor gave the patient's motor or vocal tics, do not stop for a year.The presence of other mental or nevrologicheskihrasstroystv, including the presence of childhood involuntary movement disorders such as dystonia, or psychiatric disorders, such as repetitive motion.
No special diagnostic systems and laboratory tests that can identify with precision syndrome.But some studies suggest that you can pass, may exclude comorbidities, which can give the same symptoms as Tourette's syndrome.Computed tomography (CT), electroencephalogram (EEG) and magnetic resonance imaging (MRI), or biochemical blood tests can rule out neurological pathologies occurring again.
Very often diagnosed on the basis of family history, when one of the family suffers from this disease.Many patients self-diagnosed at the disease after they discover the characteristic symptoms.If you notice in yourself or in your family above described symptoms and less severe manifestations such as decrease of attention, perseverance, unmotivated and not controlled by the things that the person himself can not explain, you must urgently turn to psycho-neurologist or neurologist.
Treatment of Tourette's syndrome
Since Tourette syndrome symptoms do not often cause any organic disorders, many patients do not need medication.Nevertheless, there are effective drugs for people who have symptoms causing expressed discomfort at work and in everyday life.
neuroleptics Group is the most accessible and effective for the suppression of motor tics.One of the most well-known representatives of this group is haloperidol.But, unfortunately, there is no single drug that would be so effective to completely remove all signs of the disease.Most antipsychotic drugs have side effects glad, for an effective treatment is necessary to slowly reduce the initial dose, when there are adverse effects.The most common side effect of antipsychotic drugs - is sedation, weight gain, cognitive dulling of reactions.Other neurological symptoms, such as tremor, dystonic reactions, such dyskinesia and parkinsonism symptoms are less common and easily controlled dose reduction.Discontinuation of antipsychotic drugs should be carried out slowly to avoid withdrawal symptoms developed (a sharp increase and strengthening of all previously manifested symptoms of the disease).
Other drugs may also be effective in reducing the severity of the disease, but most of them are not well understood and is not as effective as neuroleptics.These include drugs from the group of alpha-agonists, are representatives of clonidine and guanfacine.These drugs are used in treatment of hypertension, but also in the treatment of ticks.Distribution of these drugs have received because of the lack of sedation.
Some of the drugs that are used successfully to treat other psycho-neurological disorders, have a pronounced therapeutic effect on patients with Tourette's syndrome.Studies conducted in recent years have shown that stimulant medications such as Ritalin and dextroamphetamine may decrease symptoms without side effects.It should be noted that this group of drugs is prohibited in the Russian Federation and is used for treatment in some countries (USA, Canada and European countries).
to treat obsessive-compulsive disorder, which greatly disrupt daily condition of the patient, using drugs from the group of selective serotonin reuptake inhibitors (fluoxetine, fluvoxamine, clomipramine, paroxetine and sertraline) have been proven effective in many patients.
Psychological problems are not an integral part of Tourette's syndrome, but they can occur as a result of a complex adaptation of people.Psychotherapy can help a patient with Tourette syndrome more effectively cope with the disorders that arise in the process of social adaptation.
forecast cure Tourette's syndrome
Although there is no treatment that could fully cure the disease, the condition of many people is significantly improved in late adolescence and in later adult life.As a result, many of the patients do not need to use drugs to suppress tics.Tourette's syndrome is a chronic and even life-long disease, but any degenerative processes in the causes for human life, and threat to the lives of these people do not have.Patients with Tourette's syndrome live as long in duration as well as ordinary people, and they are not marked deterioration of intelligence.
very important to provide full support to the patient.Even despite the fact that the symptoms may decrease with age, the risk of neurobehavioral disorders such as panic attacks, depression, mood swings and antisocial behavior may persist and lead to a deterioration of the already in adult life.
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