Tourette’s syndrome

  Tourette syndrome is a syndrome characterized by motor and verbal tics. The tics of movement can occur in the head, trunk and upper and lower limbs, and the tics of facial muscles are the most common. The movements are characterized by involuntary, recurrent, rapid and purposeless movements, often with multiple groups of different muscle groups twitching at the same time, and the symptoms of tics are very diverse. The tics of speech can be manifested by peculiar screams from the larynx, unclear pronunciation of individual phonetic words or sentences, or utterance of obscene words. The disease mainly occurs between the ages of 2 and 12 years, and is more common in male children than in females, with a familial tendency to develop.  The etiology of this disease is unknown, but most people believe that it is closely related to psychiatric factors. It has been suggested that hyperactivity and aphasia syndrome are related to a variety of psychological stimuli, but currently the disorder is more often thought to be due to organic brain causes, mainly dysfunction of the basal ganglia.  Clinical manifestations The main symptom is movement, which mainly includes involuntary blinking, nodding, frowning, pouting, nose sniffing, shrugging, arm lifting, kicking, knobbing, making faces, drumming, etc., and even some develop to jumping and picking up stereotypes, with more episodes, as few as ten times a day, as many as hundreds of times a day, and more episodes when nervous and emotionally unstable, and when concentrating on certain things (such as reading, watching TV), the twitching is slightly more frequent. When concentrating on something (such as reading, watching TV), the convulsions are slightly reduced, and the general symptoms are obviously reduced or disappear during sleep, the child knows he has a disease, but it is difficult to self-control for a long time, so it can seriously affect things, hit himself, etc.; second is vocalization, vocalization is mainly manifested as bark-like growl, dry cough, light cough, clear throat, nasal sound, shushing sound, and even ranting, swearing, repeating other people’s words, etc. Seizures can occur several at the same time, the action is more life and Learning.  Treatment The main treatment is to control the symptoms, the drugs used are thiopride, haloperidol, Tolte, etc. After taking the drugs, most of the symptoms can be relieved, in addition to psychotherapy, because the disease is affected by mental factors, so parents should not be overly nervous, not to mention reproach, ridicule, scolding children, if so, not only will aggravate the symptoms of the child, but also make the drug is not easy to present the effect, so special attention should be paid.  In addition, medication should be taken under the guidance of a doctor, sensitive to drugs or long-term medication or a large number of people may appear extrapyramidal symptoms, manifested as tongue extension, mouth opening difficulties, hand and foot tremors, twisting spasms, sitting still, etc., if such a situation, promptly seek medical attention, generally with anti-convulsive paralysis drugs such as Antan tablets or after discontinuation of the drug can be expected to disappear.  The length of time it takes for the medication to be effective depends on the condition, and it generally takes 1 week to several weeks or longer for the twitching to disappear completely. If the twitching does not appear during this period, the drug can be gradually reduced and stopped under the guidance of the doctor. Otherwise, there is a risk of relapse and the symptoms may become more severe and difficult to treat.  The prognosis for tic disorders is generally good, with tic symptoms gradually decreasing or resolving on their own over time, but in a few cases the symptoms are prolonged, but generally have no effect on learning and social adjustment. The tic syndrome is a chronic neuropsychiatric disorder that requires prolonged medication to control symptoms. Corbeu followed 73 cases of Tourette’s syndrome, and after 3 to 18 years of follow-up, 2/5 of the patients recovered completely, more than half of them improved partially, and only 6% of them did not improve. The majority of patients with Tourette’s syndrome improve in late adolescence, but some continue into adulthood or even for life. It has been suggested that the prognosis is poor for patients with multiple tics and vocal tics and vocal tics that begin at the age of 4 to 6 years. A few patients have behavioral and conduct disorders or develop other psychiatric disorders, such as schizophrenia.