1/11. 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 = 1keywords = life (Clic here for more details about this article) |
2/11. Gilles de la Tourette's syndrome: a case study.Tourette's Syndrome was first described by Gilles de la Tourette in 1885. Previously thought to be a rare neuropsychiatric disorder, its prevalence is now estimated at 0.05%. In canada, this would mean approximately 12,000 people are affected. The rapid growth of knowledge in the neurosciences has led to better understanding and treatment of this disorder. Tourette's Syndrome is characterized by motor tics, usually beginning in the face and progressing to other areas, and by vocal tics, such as hissing, snorting, and barking. Fifty percent also develop copralalia. The age of onset is between 2 and 15 years of age but its complex symptomatology and its waxing and waning course delays diagnosis. This paper will describe the disease process including etiology, signs and symptoms, and treatment. The main focus will be on a case study which will depict how this syndrome affected the life of one woman. The multidisciplinary approach required to assist the severely affected individual to return to her family following successful treatment will be described.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/11. rectal prolapse in autistic children.rectal prolapse in children is not uncommon, but surgery is rarely indicated. In mentally challenged adults and children, rectal prolapse occurs more frequently than in the general population and often requires surgical intervention in the second to third decade of life. The authors describe 3 children with autism and mental retardation who presented with rectal prolapse at an earlier age than would be anticipated with mental retardation alone. All 3 children required surgical intervention.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/11. Gilles de la tourette syndrome: response to electroconvulsive therapy.tourette syndrome is a chronic disease characterized by vocal and motor ticks. self-injurious behavior is observed in one third of the patients and can be life-threatening. Current medical therapy includes dopamine receptor antagonists and atypical antipsychotics. In certain cases, there has been some evidence about the efficacy of electroconvulsive therapy (ECT). The case study below is a tourette syndrome patient with self-injurious behavior and psychotic features and poor response to medical therapy. Two years of remission was achieved after 7 sessions of ECT and carbamezapine maintance therapy. In conclusion, ECT can be used as an efficacious treatment modality for Tourette patients with self-injurious behavior, psychotic features, or for those that are unresponsive to traditional methods.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
5/11. nursing implications of Tourette's syndrome.Gilles de la tourette syndrome is a neurological disorder of gradual childhood onset which usually persists for life. Manifestations include motor, vocal and sensory tics. Behavioral manifestations such as obsessive-compulsive disorder, attention-deficit disorder and learning disabilities may also occur. nurses can play a major role in assisting patients and their families, through education and fostering effective coping mechanisms, to adjust to Tourette's syndrome. Through a case study and review of the literature, this article presents the etiology, manifestations, management and nursing implications of Tourette's syndrome.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/11. Stress management and Gilles de la Tourette's syndrome.Tourette's syndrome is a lifelong disorder characterized by multiple motor and verbal tics. The present study examined relaxation training and desensitization training as a method of reducing the frequency and intensity of tics and the distress they caused in a young adult diagnosed with Tourette's syndrome. After a period of symptom monitoring the subject underwent 3 weeks of intensive training in relaxation skills and 5 weeks of desensitization training with situational cues previously identified as eliciting Tourette's symptoms. According to self-report monitoring, the experience of symptoms was decreased across 3 global dimensions: distress (48%), frequency (48%), and intensity (50%), and an hourly symptom count (50%). Collateral parental symptom report agreed with an observed decreased across distress (40%), frequency (41%), and intensity (40%). Inspection of data suggests that both components of stress management added to total treatment efficacy.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
7/11. recurrence of complex motor and vocal tics in an elderly woman responsive to opiates.A 73-year-old woman experienced recurrence of complex and motor tics in late adult life. Involuntary vocalizations that had a cough-like quality constituted the most distressing feature of her tick disorder. The latter was unresponsive to diverse pharmacological agents including neuroleptics, clonazepam, baclofen, phenytoin, and various nonnarcotic antitussive agents. Low dose oxycodone produced almost complete abolishment of the cough-like involuntary vocalizations. This report implicates derangement in the activity of the endogenous opioid system in the pathophysiology of Tourette's syndrome, and suggest that opiates may be prescribed in the therapy of TS patients otherwise recalcitrant to administration of haloperidol or other dopamine blocking agents.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
8/11. Gilles de la tourette syndrome: a 20-month study of the effects of stressful life events and haloperidol on symptom frequency.The frequency of tics in a 10-year-old boy suffering from Gilles de la tourette syndrome was investigated in the laboratory and at home using counts of tics made by the parents. The study spanned 20 months during which time the patient was treated with haloperidol. parents' counts were reliable and valid. Stressful life events overcame positive medication effects, and symptom level varied markedly with the activities in which the child engaged. Such situational variability may explain the previously reported waxing and waning of symptoms. Findings also suggested that specific counseling be given when haloperidol is prescribed in order to prepare parents and patients for any apparent worsening of the disorder that may actually be due to the presence of stressful life events.- - - - - - - - - - ranking = 6keywords = life (Clic here for more details about this article) |
9/11. Gilles de la Tourette's syndrome: report of five cases in the Chinese.Five cases of Gilles de la Tourette's syndrome occurring in the Chinese are described. The onset, course, symptomatology and family psychopathology are similar to those reported in Caucasians. On the parameters of apgar score, psychological testing, EEG and psychiatric examination all had at least one abnormality. The response to haloperidol was uniformly good. Follow-up results showed that all were able to lead a fairly normal life after treatment. Though the cases are few in number, the findings seem to support the hypothesis that the syndrome has an organic substratum subject to psychological influences.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
10/11. Remarks on the etiology of Gilles de la Tourette's syndrome.Utilizing a case of Tourette's syndrome as an illustration, this paper seeks to refine the problem of causality in medical illness. In contrast to numerous examples reported in the literature, the patient presented in this communication, a 26-year-old man afflicted with tics, convulsive movements, intractable vomiting, and coprolalia, failed to respond favorably to medication, although he showed marked improvement in the course of psychotherapy. Despite rather transparent psychodynamic connections between his life history on the one hand and the nature and vicissitudes of his symptomatology on the other, it cannot be concluded that the psychological factors alone can account for the clinical picture; at best they may be regarded as contributory, as opposed to necessary or sufficient causes, a distinction that may be applied to other conditions as well. This report includes a review of some of the literature on Tourette's syndrome, with special emphasis on the case of Dr. Samuel Johnson, who in retrospect appears to have been a likely victim of that unfortunate malady.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
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