Tourette-obstruction syndrome, also known as multiple tics (convulsions).
It is a syndrome or behavioral disorder characterized by motor, verbal and tic movements. It mostly starts between the ages of 2 and 15, with a peak at the age of 7 to 8. It is more common in boys, with a male to female ratio of 3 to 9:1. In recent years, its incidence has increased and it has become a common disease in pediatric clinics.
Typical clinical manifestations.
Chronic, fluctuating, multiple motor muscle (muscles of the head, face, shoulders, limbs, trunk, etc.) twitches rapidly, accompanied by involuntary vocalization and speech disorders.
Most of the twitches start from the eye and facial muscles, such as blinking and tilting of the mouth, and then gradually progress to the proximal part of the limbs, and involve multiple muscle twitches throughout the body, developing from simple motor twitches to complex twitches.
The twitching usually progresses from the head and face to the neck, shoulders, upper limbs, trunk and lower limbs. The form of the twitches may change, from one form to another. The first symptoms of motor twitching or vocal twitching may occur sequentially or simultaneously.
Symptoms in this category are often aggravated by mental stress or after somatic illness, may be temporarily reduced by attentional focus, may be briefly restrained by subjective effort, and disappear during sleep.
In view of the fact that; multiple tics; and obscuriosis; are the two main features of this disease, it is named tic-obscuriosis syndrome.
Clinically, parents usually find that their children have involuntary twitching or emitting noises, even with some behavioral disorders and go to the hospital. It may even include impulsive touching of people or objects, jabbing movements, ankle feet, electroshock-like shaking of the whole body, walking gyrations, turning of the waist and arms, squatting and kneeling, or a series of continuous meaningless movements repeatedly. In severe cases, inattention, hyperactivity, obsessive-compulsive movements, obsessive thoughts, impulsivity, aggression, self-injurious behavior, learning difficulties and mood disorders may occur.
The diagnosis of pediatric tic-obstruction syndrome is not difficult based on history and signs, and is mainly based on (ICD-10 criteria).
1. The onset is mostly between the ages of 2 and 15 years.
2. There are recurrent, involuntary, repetitive, rapid, purposeless twitches that affect multiple muscle groups.
3. Multiple twitches and one or more vocal twitches, both present with some times, but not necessarily both.
4.Can be controlled by will for several minutes to 10 minutes.
5. The intensity of symptoms varies over weeks or months.
6.Twitching occurs several times a day, almost every day. The duration of the disease is more than one year, and the symptoms do not remit for more than two months in the same year.
7. Exclude rheumatic chorea, Huntington’s disease, hepatomegaly, epileptic myoclonic seizures, acute movement disorder, hysterical spasms, pharmacogenic involuntary movements, childhood schizophrenia and other extravertebral lesions.
Treatment
In the treatment is Western medicine mostly used dopamine receptor blocker haloperidol, anti-dopaminergic active drug Tebri, adrenergic drug colistin, etc. However, because Western medicine can only symptomatically control the tic symptoms, and the control time is short, after stopping the drug may appear more serious tics, coupled with the side effects of Western medicine, so the efficacy is not ideal, lack of long-term application of efficacy guarantee. In addition, psychotherapy, relaxation therapy and biofeedback therapy also have certain efficacy.
Traditional Chinese medicine in China is based on the concept of holistic and evidence-based treatment as its basic idea, which is used in the theoretical system of diagnosis, identification and treatment of Chinese medicine. In the process of understanding diseases, TCM first focuses on the whole body, that is, it pays attention to the impact of lesions in one part of the human body on other parts of the body, and pays attention to the connection between organs, bowels, forms and orifices, as well as the connection between the five organ systems, and considers the human body as a whole with the heart as the master and the five organs as the center, and at the same time believes that human beings and the natural world
At the same time, he believes that there is a close connection between human beings and nature and society. In diagnosis and treatment, TCM advocates identifying the causes, examining the causes and treating the root of the disease, regulating the internal organs, regulating the qi and blood, and adapting to the time, place and person. Therefore, the diagnosis and treatment of diseases in Chinese medicine are based on reason and evidence, for different stages of development of the same disease and the same pathological manifestations of different diseases, taking into account the individual differences between people, so that the clinical identification and typing, the examination of causes and the use of drugs are more objective and rationalized, and the results are often very strange.
Based on years of clinical experience in the treatment of pediatric tic-obscene syndrome, the disease is divided into three types.
(1) Kidney-yin deficiency and liver-yang resistance
(2) Dampness and heat with phlegm and fire disturbing the heart
(3) Spleen deficiency and liver exuberance, internal movement of liver wind.
The latter two types are the most common in clinical practice, and we formulated the basic formula of twitching spirit to add and subtract drugs according to the different symptoms of each child, and took 2 months as a course of treatment, observing 2~3 courses of treatment, the children’s twitching symptoms were significantly improved. The exact therapeutic effect and abundant clinical examples confirm the unshakable superiority of TCM in the treatment of tic-obscene syndrome, which is a clinically difficult disease, and further proves the far-reaching exploration significance and profound development potential of TCM.