The following are the most important disorders or complications that may be contributed to by Tourette syndrome: Psyche – Nervous System (F00-F99; G00-G99). Anxiety disorders Depression Social phobia Decreased self-esteem
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Head and face to determine motor and vocal tics occurring in type, frequency, intensity, complexity Entire body [motor tics] Neurological examination[due todifferential diagnoses: Huntington’s chorea (synonyms: Huntington’s chorea or … Tourette Syndrome: Examination
Causal (cause-related) therapy is not possible. Therapy goals Symptomatic therapy: tic reduction. Therapy of comorbidities (concomitant diseases) – see under the respective disease. Therapy recommendations To date, few controlled trials of drug treatment for tics are available. The following neuroleptics (dopamine receptor antagonists) are used in the treatment of tics: Classical antipsychotics (KAP). Haloperidol, pimozide … Tourette Syndrome: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. For neurologic deficits: Magnetic resonance imaging of the skull (cranial MRI, cranial MRI or cMRI). Encephalogram (EEG; recording of the electrical activity of the brain).
If adults are affected by severe tics that cannot be relieved by other means, deep brain stimulation (THS; “brain pacemaker“) may be performed. This is a reversible (reversible) neurosurgical procedure that can be performed not only in Tourette’s syndrome, but also in other neurological disorders such as dystonia (disorder of conduction in the nervous system), … Tourette Syndrome: Surgical Therapy
To prevent Tourette syndrome, attention must be paid to reducing individual risk factors. Behavioral risk factors Pleasure food consumption Tobacco (smoking) in gravidity (pregnancy). Psycho-social situation Stress during gravidity
The following symptoms and complaints may indicate Tourette syndrome: Leading symptom Tics – motor combined with vocal. motor tics: Uvoluntary, sometimes violent, movements not related to a specific purpose. Suddenly shoot in They are always the same movements, which can occur individually, serially (several times a day) or only in stressful situations vocal (phonetic) tics: … Tourette Syndrome: Symptoms, Complaints, Signs
Pathogenesis (development of the disease) The origin of the neurological disorder is the corpus striatum (“striate body”), which is a part of the basal ganglia. The basal ganglia are a group of endbrain and diencephalic nuclei (nuclei basales) that are of great importance for motor, as well as cognitive and limbic, regulation. The corpus striatum, … Tourette Syndrome: Causes
Psychotherapy Behavioral therapy (VT) – for sufferers aged 10 and older. Indication: mild courses Benefit: Relief of tics (up to 30%). Strengthening of self-awareness Breaking the behavioral chains by learning competing behaviors. The following VT are offered: Habit-reservational training (HRT) (“reaction reversal treatment”) – learning an alternative behavior to prevent tics. Exposure and Response Prevention … Tourette Syndrome: Therapy
The medical history (history of illness) represents an important component in the diagnosis of Tourette syndrome. If the affected person is a child, the history should be directed to the parents. Family history What is the general health of your relatives? Are there any hereditary diseases in your family? Social history Is there any evidence … Tourette Syndrome: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Fragile X syndrome (Martin-Bell syndrome) – X-linked inherited syndrome in which the main malformations are: large auricles, large genitalia, sterility (infertility), and mental retardation; may be associated with tics (secondary tics) (rare) Endocrine, nutritional, and metabolic disorders (E00-E90). Wilson’s disease (copper storage disease) – autosomal recessive inherited disorder … Tourette Syndrome: Or something else? Differential Diagnosis
