1/17. Late onset startle induced tics.Three cases of late onset Gilles de la Tourette's syndrome are presented. The motor tics were mainly induced by an unexpected startling stimulus, but the startle reflex was not exaggerated. The tics developed after physical trauma or a period of undue emotional stress. reflex tics may occur in Gilles de la Tourette's syndrome, but have not been described in late onset Tourette's syndrome. Such tics must be distinguished from psychogenic myoclonus and the culture bound startle syndromes.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/17. Tourette's disorder: epidemiology and comorbidity in primary school children.OBJECTIVE: To study prevalence and comorbidity of Tourette's disorder in the general population of children and in a clinical setting. methods: School-age children in the general population and children attending a county-wide tic disorder clinic were screened and examined by the same doctor. Behavioral-psychometric instruments with demonstrated reliability and validity were used. RESULTS: Depending on the sample characteristics, 0.15% to 1.1% of all children had Tourette's disorder. Boys outnumbered girls by 4:1 through 6:1. attention deficits and empathy/autism spectrum problems (including Asperger's disorder) were very common, each type of comorbidity affecting approximately two thirds of individuals with Tourette's disorder. overall behavior problem scores were high, and affected children exhibited a marked degree of functional impairment. CONCLUSIONS: Tourette's disorder is a common disorder with high rates of significant comorbidity. In most cases, attention deficits and empathy problems are likely to cause more suffering than the tics per se.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
3/17. Candidate region for Gilles de la tourette syndrome at 7q31.Gilles de la tourette syndrome (GTS) is a complex neuropsychiatric disorder characterized by motor and vocal tics. The cause of this syndrome is unknown, although based on family studies there is evidence of a strong genetic component. We report on a 13-year-old boy with GTS, minor physical anomalies, and a de novo partial duplication of chromosome 7q [dup(7)(q22.1-q31.1)]. The distal breakpoint in our patient is similar to the breakpoint of an apparently balanced familial translocation t(7;18) segregating with GTS. Together, these cases provide evidence that a gene located in the breakpoint region at 7q31 can be involved in the formation of GTS.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/17. Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal by risperidone and melatonin.A patient with Gilles de la tourette syndrome treated with haloperidol, ingested once daily after awakening from sleep, exhibited an irregular sleep-wake pattern with a free-running component of approximately 48 h. Transfer to risperidone, ingested once daily after awakening from sleep, was beneficial resulting in a sleep-wake cycle more synchronized at the appropriate phase to the external zeitgebers, and fewer nocturnal disturbances. The circadian sleep-wake schedule was fully synchronized when the patient had been subsequently treated with melatonin at 21:00h, before intended nocturnal sleep, in addition to risperidone in the morning. Restoration of the sleep-wake circadian pattern was accompanied by the patient's subjective report of significant improvement in his quality of life, social interactions, and occupational status. This observation suggests that circadian rhythm sleep disorders can be related to the typical neuroleptic haloperidol and restored by the atypical neuroleptic risperidone. Similar findings reported in patients suffering from other disorders support the hypothesis that the described disruption of the sleep-wake schedule is medication rather than illness-related. Therefore, it is very important to realize that circadian rhythm sleep disorders may be a side effect of neuroleptics.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
5/17. Anti-inflammatory therapy with a COX-2 inhibitor in Tourette's syndrome.An infectious/inflammatory process plays a role in at least a subgroup of patients with tics and Tourette's syndrome (TS). Successful antibiotic therapy and prophylaxis was described repeatedly. We report the case of a patient suffering from chronic TS who was treated with celecoxib additionally to the antibiotic prophylaxis. This treatment was associated with a continuous improvement of tics and disturbed behaviour, such as aggression and social withdrawal. The withdrawal of celecoxib led to a marked deterioration in TS symptoms while the re-exposition had advantageous therapeutic effects. This result of the treatment with a COX-2 inhibitor supports the view that COX-2 inhibitors show therapeutic benefit in patients suffering from psychiatric disorders in which an inflammatory process is involved in the pathophysiology.- - - - - - - - - - ranking = 16.722310930469keywords = suffering (Clic here for more details about this article) |
6/17. Tic or compulsion?: it's Tourettic OCD.A subgroup of individuals suffering from obsessive-compulsive disorder (OCD) frequently present to treatment with an atypical yet distinguishable array of symptoms akin to both Tourette's disorder (TD) and OCD. These individuals often receive standard treatments for OCD (or less likely, TD) that fail to address the blended features of their presentation. It is argued that these individuals would be better served, both psychotherapeutically and pharmacologically, by the adoption of a Tourettic OCD (TOCD) conceptual framework.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
7/17. A case of tourette syndrome presenting with oral self-injurious behaviour.Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
8/17. deep brain stimulation in Tourette's syndrome: two targets?In this report, we describe the effects of bilateral thalamic stimulation in one patient and of bilateral pallidal stimulation in another patient. Both patients suffered from intractable Tourette's syndrome (TS). Any conservative treatment had failed or had been stopped because of unbearable side effects in the 2 patients. In both cases, there was no comorbidity except for associated behavioral symptoms (compulsions). electrodes were implanted at the level of the medial part of the thalamus (centromedian nucleus, the substantia periventricularis, and the nucleus ventro-oralis internus) in one patient and in the posteroventral part of the globus pallidus internus (GPi) in the other patient. In both cases, deep brain stimulation (DBS) resulted in a substantial reduction of tics and compulsions. These data show that bilateral DBS of the thalamus as well as of the GPi can have a good effect on tics and behavioral symptoms in patients suffering from intractable TS.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
9/17. Concomitant use of atomoxetine and OROS-methylphenidate in a 10-year-old child suffering from attention-deficit/hyperactivity disorder with comorbid bipolar disorder and tourette syndrome.Atomoxetine and OROS methylphenidate were successfully used concomitantly in a 10-year-old boy suffering from attention-deficit/hyperactivity disorder (ADHD) with comorbid bipolar disorder and tourette syndrome (TS). The child received valproic acid, clonidine, and ziprasidone concurrently. Because possible side effects of pharmacological treatment for one diagnosis may exacerbate a comorbid condition, contingent management strategies, when using polypharmacy, are mandated.- - - - - - - - - - ranking = 41.805777326172keywords = suffering (Clic here for more details about this article) |
10/17. Helping your patient cope with tourette syndrome.tourette syndrome is a neurological disorder of unknown origin. The individual suffering from tourette syndrome encounters tics and often additional behaviors such as speech, sleep, and learning difficulties, as well as social isolation.- - - - - - - - - - ranking = 8.3611554652344keywords = suffering (Clic here for more details about this article) |
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