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Ailmemts & Remedies

Tourette Syndrome

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Alternative Names: Tourette’s syndrome, Tourette’s disorder, Gilles de la Tourette syndrome, GTS or, more commonly, simply Tourette’s or TS

Definition:
Tourette syndrome  is an inherited neuropsychiatric disorder with onset in childhood, characterized by multiple physical (motor) tics and at least one vocal (phonic) tic; these tics characteristically wax and wane. Tourette’s is defined as part of a spectrum of tic disorders, which includes transient and chronic tics.

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Tourette’s was once considered a rare and bizarre syndrome, most often associated with the exclamation of obscene words or socially inappropriate and derogatory remarks (coprolalia), but this symptom is present in only a small minority of people with Tourette’s. Tourette’s is no longer considered a rare condition, but it may not always be correctly identified because most cases are classified as mild. Between 1 and 10 children per 1,000 have Tourette’s; as many as 10 per 1,000 people may have tic disorders, with the more common tics of eye blinking, coughing, throat clearing, sniffing, and facial movements. Tourette’s does not adversely affect intelligence or life expectancy. The severity of the tics decreases for most children as they pass through adolescence, and extreme Tourette’s in adulthood is a rarity. Notable individuals with Tourette’s are found in all walks of life.

Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

Clacification
Tics are sudden, repetitive, stereotyped, nonrhythmic movements (motor tics) and utterances (phonic tics) that involve discrete muscle groups.[8] Motor tics are movement-based tics, while phonic tics are involuntary sounds produced by moving air through the nose, mouth, or throat.

Tourette’s is one of several tic disorders, which are classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM) according to type (motor or phonic tics) and duration (transient or chronic). Transient tic disorder consists of multiple motor tics, phonic tics or both, with a duration between four weeks and twelve months. Chronic tic disorder is either single or multiple, motor or phonic tics (but not both), which are present for more than a year. Tourette’s is diagnosed when multiple motor tics, and at least one phonic tic, are present for more than a year. Tic disorders are defined similarly by the World Health Organization (International Statistical Classification of Diseases and Related Health Problems, ICD-10 codes).

Although Tourette’s is the more severe expression of the spectrum of tic disorders, most cases are mild. The severity of symptoms varies widely among people with Tourette’s, and mild cases may be undetected

Symptoms:
Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. Symptoms range from mild to severe and debilitating.

Tics are classified as either:
*Simple tics, which are sudden, brief and repetitive and involve a limited number of muscle groups

*Complex tics, which are distinct, coordinated patterns of movements involving several muscle groups

Tics involving movement (motor tics) — often facial tics, such as blinking — usually begin before vocal tics do. But the spectrum of tics that people experience is diverse, and there’s no typical case.

Some of the more common tics seen in Tourette syndrome
Motor tics:-

Simple tics:
*Eye blinking
*Head jerking
*Shoulder shrugging
*Eye darting
*Finger flexing
*Sticking the tongue out

Complex tics :
*Touching the nose
*Touching other people
*Smelling objects
*Obscene gestures
*Flapping the arms
*Hopping

Vocal tics:-

Simple tics :
*Hiccuping
*Yelling
*Throat clearing
*Barking

Complex tics :
*Using different voice intonations
*Repeating one’s own words or phrases
*Repeating others’ words or phrases
*Using expletives

Tics can vary in type, frequency and severity over time. They may worsen during periods of stress and anxiety, fatigue, illness, or excitement. They can occur during sleep. You’ll likely experience an urge, called a premonitory urge, before the onset of motor or vocal tics. A premonitory urge is an uncomfortable bodily sensation, such as an itch, a tingle or tension. Expression of the tic brings relief.

Different tics may develop over time. Tourette symptoms are usually at their worst during the teenage years and sometimes improve during the transition to adulthood.

With great effort, some people with Tourette syndrome can sometimes temporarily stop a tic or hold back tics until they find a place where it’s less disruptive to express them.

 

Causes:
The exact cause of Tourette’s is unknown, but it is well established that both genetic and environmental factors are involved. Genetic studies have shown that the overwhelming majority of cases of Tourette’s are inherited, although the exact mode of inheritance is not yet known, and no gene has been identified. In some cases, Tourette’s is sporadic, that is, it is not inherited from parents. In other cases, tics are associated with disorders other than Tourette’s, a phenomenon known as tourettism.

A person with Tourette’s has about a 50% chance of passing the gene(s) to one of his or her children, but Tourette’s is a condition of variable expression and incomplete penetrance. Thus, not everyone who inherits the genetic vulnerability will show symptoms; even close family members may show different severities of symptoms, or no symptoms at all. The gene(s) may express as Tourette’s, as a milder tic disorder (transient or chronic tics), or as obsessive–compulsive symptoms without tics. Only a minority of the children who inherit the gene(s) have symptoms severe enough to require medical attention. Gender appears to have a role in the expression of the genetic vulnerability: males are more likely than females to express tics.

Non-genetic, environmental, infectious, or psychosocial factors—while not causing Tourette’s—can influence its severity. Autoimmune processes may affect tic onset and exacerbation in some cases. In 1998, a team at the US National Institute of Mental Health proposed a hypothesis that both obsessive–compulsive disorder (OCD) and tic disorders may arise in a subset of children as a result of a poststreptococcal autoimmune process. Children who meet five diagnostic criteria are classified, according to the hypothesis, as having Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS).  This contentious hypothesis is the focus of clinical and laboratory research, but remains unproven.

The exact mechanism affecting the inherited vulnerability to Tourette’s has not been established, and the precise etiology is unknown. Tics are believed to result from dysfunction in cortical and subcortical regions, the thalamus, basal ganglia and frontal cortex. Neuroanatomic models implicate failures in circuits connecting the brain’s cortex and subcortex, and imaging techniques implicate the basal ganglia and frontal cortex.

Some forms of OCD may be genetically linked to Tourette’s. A subset of OCD is thought to be etiologically related to Tourette’s and may be a different expression of the same factors that are important for the expression of tics.   The genetic relationship of ADHD to Tourette syndrome, however, has not been fully established

Risk factors
Having a family history of Tourette syndrome or other tic disorders may increase the risk of developing Tourette syndrome.

Complication:
People with Tourette syndrome have a normal life span and often lead a healthy, active life. However, having Tourette syndrome may increase the risk of learning, behavioral and social challenges, which can mar self-image.

In addition, having Tourette syndrome means you’re likely to have other related conditions, such as:

*Attention-deficit/hyperactivity disorder (ADHD)

*Obsessive-compulsive disorder

*Learning disabilities

*Sleep disorders

*Depression

*Anxiety disorders

Diagnosis:
According to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), Tourette’s may be diagnosed when a person exhibits both multiple motor and one or more vocal tics (although these do not need to be concurrent) over the period of a year, with no more than three consecutive tic-free months. The previous DSM-IV included a requirement for “marked distress or significant impairment in social, occupational or other important areas of functioning”, but this requirement was removed in the most recent update of the manual, in recognition that clinicians see patients who meet all the other criteria for Tourette’s, but do not have distress or impairment.[44] The onset must have occurred before the age of 18, and cannot be attributed to the “direct physiological effects of a substance or a general medical condition”. Hence, other medical conditions that include tics or tic-like movements—such as autism or other causes of tourettism—must be ruled out before conferring a Tourette’s diagnosis.

There are no specific medical or screening tests that can be used in diagnosing Tourette’s; it is frequently misdiagnosed or underdiagnosed, partly because of the wide expression of severity, ranging from mild (the majority of cases) or moderate, to severe (the rare, but more widely-recognized and publicized cases). Coughing, eye blinking and tics that mimic asthma are commonly misdiagnosed.

The diagnosis is made based on observation of the individual’s symptoms and family history, and after ruling out secondary causes of tic disorders. In patients with a typical onset and a family history of tics or obsessive–compulsive disorder, a basic physical and neurological examination may be sufficient.

There is no requirement that other comorbid conditions (such as ADHD or OCD) be present, but if a physician believes that there may be another condition present that could explain tics, tests may be ordered as necessary to rule out that condition. An example of this is when diagnostic confusion between tics and seizure activity exists, which would call for an EEG, or if there are symptoms that indicate an MRI to rule out brain abnormalities.  TSH levels can be measured to rule out hypothyroidism, which can be a cause of tics. Brain imaging studies are not usually warranted. In teenagers and adults presenting with a sudden onset of tics and other behavioral symptoms, a urine drug screen for cocaine and stimulants might be necessary. If a family history of liver disease is present, serum copper and ceruloplasmin levels can rule out Wilson’s disease. Most cases are diagnosed by merely observing a history of tics.

Secondary causes of tics (not related to inherited Tourette syndrome) are commonly referred to as tourettism. Dystonias, choreas, other genetic conditions, and secondary causes of tics should be ruled out in the differential diagnosis for Tourette syndrome.  Other conditions that may manifest tics or stereotyped movements include developmental disorders, autism spectrum disorders, and stereotypic movement disorder;  Sydenham’s chorea; idiopathic dystonia; and genetic conditions such as Huntington’s disease, neuroacanthocytosis, Hallervorden-Spatz syndrome, Duchenne muscular dystrophy, Wilson’s disease, and tuberous sclerosis. Other possibilities include chromosomal disorders such as Down syndrome, Klinefelter’s syndrome, XYY syndrome and fragile X syndrome. Acquired causes of tics include drug-induced tics, head trauma, encephalitis, stroke, and carbon monoxide poisoning. The symptoms of Lesch-Nyhan syndrome may also be confused with Tourette syndrome. Most of these conditions are rarer than tic disorders, and a thorough history and examination may be enough to rule them out, without medical or screening tests
Treatment:
There’s no cure for Tourette syndrome. Treatment is intended to help control tics that interfere with everyday activities and functioning. When tics aren’t severe, treatment may be unnecessary.

Medications:
No medication is helpful to everyone with Tourette syndrome, none completely eliminates symptoms, and they all have side effects to be weighed against the benefits. However, some medications can be used to help control or minimize tics or to control symptoms of related conditions, such as attention-deficit/hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). These may include:

*Drugs that block or deplete the neurotransmitter dopamine in the brain, such as fluphenazine or pimozide (Orap). Used to control tics, these medications may have side effects such as weight gain and a dulling of the mind.

*Botulinum Toxin Type A (Botox) injections. For simple or vocal tics, an injection into the affected muscle may help relieve the tic.

*Stimulant medications, such as methylphenidate (Concerta, Ritalin, others) and dextroamphetamine (Dexedrine, others). These are used to help increase attention and concentration for people with ADHD.

*Central adrenergic inhibitors, such as clonidine (Catapres) or guanfacine (Tenex). Typically prescribed for high blood pressure, these drugs may help control behavioral symptoms, such as impulse control problems and rage attacks. Side effects may include sleepiness.

*Antidepressants, such as fluoxetine (Prozac, Sarafem, others). These may help control the symptoms of OCD.

Therapies
*Psychotherapy. Psychotherapy can be helpful for two reasons. It can help with accompanying problems, such as ADHD, obsessions, depression and anxiety. Therapy can also help people cope with Tourette syndrome.

*Deep brain stimulation. For debilitating tics that don’t respond to other treatment, deep brain stimulation (DBS) may help. DBS consists of implanting a battery-operated medical device (neurostimulator) in the brain to deliver electrical stimulation to targeted areas that control movement. Further research is needed to determine whether DBS is beneficial for people with Tourette syndrome.

 

Prognosis:
Tourette syndrome is a spectrum disorder—its severity ranges over a spectrum from mild to severe. The majority of cases are mild and require no treatment. In these cases, the impact of symptoms on the individual may be mild, to the extent that casual observers might not know of their condition. The overall prognosis is positive, but a minority of children with Tourette syndrome have severe symptoms that persist into adulthood. A study of 46 subjects at 19 years of age found that the symptoms of 80% had minimum to mild impact on their overall functioning, and that the other 20% experienced at least a moderate impact on their overall functioning. The rare minority of severe cases can inhibit or prevent individuals from holding a job or having a fulfilling social life. In a follow-up study of thirty-one adults with Tourette’s, all patients completed high school, 52% finished at least two years of college, and 71% were full-time employed or were pursuing higher education.

Regardless of symptom severity, individuals with Tourette’s have a normal life span. Although the symptoms may be lifelong and chronic for some, the condition is not degenerative or life-threatening. Intelligence is normal in those with Tourette’s, although there may be learning disabilities. Severity of tics early in life does not predict tic severity in later life, and prognosis is generally favorable, although there is no reliable means of predicting the outcome for a particular individual. The gene or genes associated with Tourette’s have not been identified, and there is no potential “cure”. A higher rate of migraines than the general population and sleep disturbances are reported.

Several studies have demonstrated that the condition in most children improves with maturity. Tics may be at their highest severity at the time that they are diagnosed, and often improve with understanding of the condition by individuals and their families and friends. The statistical age of highest tic severity is typically between eight and twelve, with most individuals experiencing steadily declining tic severity as they pass through adolescence. One study showed no correlation with tic severity and the onset of puberty, in contrast with the popular belief that tics increase at puberty. In many cases, a complete remission of tic symptoms occurs after adolescence. However, a study using videotape to record tics in adults found that, although tics diminished in comparison with childhood, and all measures of tic severity improved by adulthood, 90% of adults still had tics. Half of the adults who considered themselves tic-free still displayed evidence of tics.

It is not uncommon for the parents of affected children to be unaware that they, too, may have had tics as children. Because Tourette’s tends to subside with maturity, and because milder cases of Tourette’s are now more likely to be recognized, the first realization that a parent had tics as a child may not come until their offspring is diagnosed. It is not uncommon for several members of a family to be diagnosed together, as parents bringing children to a physician for an evaluation of tics become aware that they, too, had tics as a child.

Children with Tourette’s may suffer socially if their tics are viewed as “bizarre”. If a child has disabling tics, or tics that interfere with social or academic functioning, supportive psychotherapy or school accommodations can be helpful.  Because comorbid conditions (such as ADHD or OCD) can cause greater impact on overall functioning than tics, a thorough evaluation for comorbidity is called for when symptoms and impairment warrant.

A supportive environment and family generally gives those with Tourette’s the skills to manage the disorder.  People with Tourette’s may learn to camouflage socially inappropriate tics or to channel the energy of their tics into a functional endeavor. Accomplished musicians, athletes, public speakers, and professionals from all walks of life are found among people with Tourette’s. Outcomes in adulthood are associated more with the perceived significance of having severe tics as a child than with the actual severity of the tics. A person who was misunderstood, punished, or teased at home or at school will fare worse than children who enjoyed an understanding and supportive environment

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources;
http://en.wikipedia.org/wiki/Tourette_syndrome
http://www.mayoclinic.com/health/tourette-syndrome/DS00541

http://www.sfn.org/index.aspx?pagename=brainBriefings_tourette#full

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Categories
Ailmemts & Remedies

Movement Disorders

Introduction:
Movement disorders are a group of nervous system (neurological) conditions that cause you to have abnormal voluntary or involuntary movements, or slow, reduced movements.
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Even a simple action such as picking up a pencil engages several different parts of the brain. The conscious thought areas of the brain trigger the motor area to send signals to the muscles of the arm.

As the movement begins, sensors in the arm are activated, sending signals back into different areas of the brain that interpret them and then send further messages to the motor area to fine tune power, speed, coordination and balance.

Given such complexity, problems with the control of movement are understandably widespread. Essential tremor – the most common movement disorder – affects one in 20 people under the age of 40 and one in five people over 65. Up to one in ten people has restless legs syndrome.

Other conditions such as Parkinson’s disease (which affects one in 500 people) are less common, but can severely impair quality of life because they reduce the independence of those affected.

Types:
There are various types of  Movement disorders and that include :

*Ataxia. Ataxia is a neurological condition that affects the part of your brain that controls coordinated movement (cerebellum). Ataxia may cause uncoordinated movements, imbalance and other symptoms.

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*Dystonia. Dystonia is a neurological condition in which your muscles contract involuntarily and may cause twisting and repetitive movements. Dystonia may involve the entire body (generalized dystonia) or one part of the body (focal dystonia).

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*Essential tremor. Essential tremor is a neurological condition that causes involuntary shaking (tremors). Your hands often are affected, but other parts of your body also may be affected.

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*Huntington’s disease. Huntington’s disease is an inherited progressive, neurodegenerative disorder that causes certain nerve cells in your brain to deteriorate. This condition may cause uncontrolled movements, decreased thinking abilities (cognitive abilities), and emotional and mental health disturbances (psychiatric conditions).

You may click to see

*Multiple system atrophy. Multiple system atrophy is an uncommon, progressive neurological disorder that affects many areas of your brain and nervous system. Multiple system atrophy may cause ataxia or parkinsonism. This condition frequently impairs body systems that modulate your blood pressure, heart rate and bladder function (autonomic function).

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*Myoclonus.:  Myoclonus is a condition in which you have sudden, jerky movements, twitching, or intermittent spasms of a muscle or group of muscles.

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*Parkinson’s disease. Parkinson’s disease is a progressive neurological disorder that affects your movement and may cause shaking (tremor), muscle stiffness (rigidity), slowing of movement, impaired balance or other symptoms. Parkinsonism describes a group of conditions that has symptoms similar to those of Parkinson’s disease.

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*Progressive supranuclear palsy. Progressive supranuclear palsy is a rare neurological disorder that causes you to have problems with walking, balance and eye movements. It resembles Parkinson’s disease but is a distinct condition.

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*Restless legs syndrome. Restless legs syndrome causes unpleasant, abnormal feelings in your legs while you’re relaxing or lying down. Your symptoms often are relieved by movement.
Tardive dyskinesia. Tardive dyskinesia is a neurological condition caused by long-term use of certain drugs used to treat psychiatric conditions (neuroleptic drugs). Tardive dyskinesia causes repetitive and involuntary movements such as grimacing, eye blinking and other movements.

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*Tourette syndrome. Tourette syndrome is a neurological condition which starts between childhood and teenage years and is associated with repetitive movements (motor tics) and vocal sounds (vocal tics).

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*Wilson’s disease. Wilson’s disease is an inherited (genetic) disorder that causes excessive amounts of copper to build up in your body, causing neurological problems.

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Treatment :Treatment depends upon the underlying disorder

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Movement_disorder
http://www.bbc.co.uk/health/physical_health/conditions/movementdisorders1.shtml
http://www.ganeurosurg.org/specialties/movementdisorders.htm
http://www.mayoclinic.org/movement-disorders/

Dystonia


http://wiki.ggc.usg.edu/mediawiki/index.php/Essential_Tremor
http://www.bothbrainsandbeauty.com/academic-discussions/huntingtons-disease-991
http://www.chelationtherapyonline.com/anatomy/p3.htm

http://fisioterapiananeurologia.blogspot.com/2011/05/ataxia-de-friedreich.html

http://www.movementdisorders.org/james_parkinson/early_atypical.html

http://hpathy.com/cause-symptoms-treatment/restless-legs-syndrome/

Tourette’s Syndrome Pictures

http://www.eurowilson.org/en/living/guide/what/index.phtml

Categories
Ailmemts & Remedies

Tics

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Definition:
Tics are purposeless, rapid and repeated contractions of a group of muscles that result in movement (a motor tic) or the production of a sound (a vocal tic). Sometimes, a tic involves more complex behaviour.

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Motor tics often involve the muscles of the face, head and neck, with movements such as blinking, lip smacking, facial twitching, grimacing and shrugging of the shoulders. Common vocal tics include coughing, grunting or clearing the throat.

The intensity of a tic can vary. Occasionally, tics are forceful, which can be frightening and uncomfortable.

Tics aren’t voluntary movements – in other words, they can’t be consciously controlled – although some people say they feel a strong urge to move, linked to stress. Some people are able to suppress their tics briefly, but this is said to be like holding back a sneeze and tension rises until the tic finally escapes.

Tics are usually divided into several categories, as described below.:-

Transient tic disorders:-
As many as one in ten children will develop a transient or simple tic at some point during their school years. Such tics usually occur in just one muscle group and don’t last more than a few months, although a child may have a series of different transient tics over a period of years.

Transient motor tics may include blinking, squinting, snapping the fingers, jerking the head or wrinkling the nose. Occasionally, transient vocal tics such as gurgling or humming occur. The tic may even involve more bizarre behaviour, such as touching objects or licking.

Transient tics may become more prominent when a child is tired or excited, but they don’t lead to harm and don’t need treatment. They decrease or disappear when the child sleeps.

Chronic tic disorders:-
Not only do chronic tics persist, sometimes for years, but they change little in their character. While they don’t usually need treatment, they can be disruptive, especially if a child realises others think them strange. Occasionally, a person has several tics and is said to have chronic multiple tics.

Tourette syndrome:
Chronic tics are also a feature of Tourette syndrome. This neurological disorder causes multiple motor and vocal tics, which can be quite dramatic and frequently change in nature. Tourette syndrome usually begins in early childhood, varies in intensity and lasts more than a year.

Tourette can be particularly debilitating because the vocal tics can include the uncontrollable use of obscene language (known as coprolalia) and repetition of phrases the person hears others use (called echolalia).

Those with Tourette syndrome often have a variety of psychological problems too, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and self-harm behaviour, although the link isn’t clear.

Like other tics, the exact cause of Tourette syndrome isn’t known, although genetics appear to play a part. It’s likely that a particular gene makes a person more vulnerable than others to environmental factors that also contribute to the condition.

Simple tics:-
Simple motor tics are typically sudden, brief, meaningless movements that usually involve only one group of muscles, such as eye blinking, head jerking or

shoulder shrugging.   Motor tics can be of an endless variety and may include such movements as hand clapping, neck stretching, mouth movements, head, arm or leg jerks, and facial grimacing.

A simple phonic tic can be almost any sound or noise, with common vocal tics being throat clearing, sniffing, or grunting.

Complex tics:-
Complex motor tics are typically more purposeful-appearing and of a longer nature. They may involve a cluster of movements and appear coordinated.Examples of complex motor tics are pulling at clothes, touching people, touching objects, echopraxia and copropraxia.

Complex phonic tics may fall into various series (categories), including echolalia (repeating words just spoken by someone else), palilalia (repeating one’s own previously spoken words), lexilalia (repeating words after reading them) and coprolalia (the spontaneous utterance of socially objectionable or taboo words or phrases). Coprolalia is a highly publicized symptom of Tourette syndrome; however, only about 10% of TS patients exhibit coprolalia.Complex tics are rarely seen in the absence of simple tics. Tics “may be challenging to differentiate from compulsions”, as in the case of klazomania (compulsive shouting).

•Simple motor tics involve a single muscle group.
•Complex motor tics usually involve more than one muscle group.
•Complex vocal tics involve more meaningful speech (such as words) than simple vocal tics.
•Complex motor tics aren’t as rapid as simple motor tics and can even look like the person is performing the tic on purpose.

Shoulder shrugging is one of the most common simple motor tics; others include:
•nose wrinkling
•head twitching
•eye blinking
•lip biting
•facial grimacing
•repetitive or obsessive touching
•kicking
•jumping

Common vocal tics include:
•coughing
•throat clearing
•grunting
•sniffing
•barkingTransient vs. Chronic Tics

Transient vs. Chronic Tics:-
It’s perfectly normal to worry that a tic may never go away. Fortunately, that’s not usually the case. Most tics are temporary and are known as transient tics. They tend to not last more than 3 months at a time.In rarer instances people have tics that persist for an extended period of time. This is known as chronic tic disorder. These tics last for more than a year. Chronic tics can be either motor or vocal, but not both together.

Dignosis:
Tics can sometimes be diagnosed at a regular checkup after the doctor asks a bunch of questions. No specific test can diagnose tics, but sometimes doctors will run tests to rule out other conditions that might have symptoms similar to tics.

Tic disorders occur along a spectrum, ranging from mild to more severe, and are classified according to duration and severity (transient tics, chronic tics, or Tourette syndrome). Tourette syndrome is the more severe expression of a spectrum of tic disorders, which are thought to be due to the same genetic vulnerability. Nevertheless, most cases of Tourette syndrome are not severe.    The treatment for the spectrum of tic disorders is similar to the treatment of Tourette syndrome.

Differential diagnosis:
Tourettism refers to the presence of Tourette-like symptoms in the absence of Tourette syndrome as the result of other diseases or conditions—also known as secondary causes. Although tic disorders are commonly considered to be childhood syndromes, tics occasionally develop during adulthood; adult-onset tics often have a secondary cause. Tics that begin after the age of 18 are generally not considered symptoms of Tourette’s syndrome.

Tics must be distinguished from fasciculations. Small twitches of the upper or lower eyelid, for example, are not tics, because they do not involve a whole muscle. They are twitches of a few muscle fibre bundles, which one can feel but barely see

The Embarrassment Factor
Many times, people don’t see themselves having a tic — they’re not walking around with a huge mirror at all times! So it’s only natural that they may think that their tic is the worst tic ever. Of course it isn’t, but it’s still a concern for many people with tics. And these exaggerated thoughts can cause unnecessary feelings of embarrassment or angst, and actually make the tic worse.

The tic might seem to begin either for no appreciable reason, or perhaps be incited by something like an eye irritation which begins a cycle of blinking that doesn’t stop when the irritation is gone. The simple tic usually goes away in six months or so, seemingly sooner if the child is not being reminded of it all the time by his family.

Sometimes the symptoms become more chronic. If the symptoms are limited to muscular movements, the condition is called multiple chronic motor tic disorder. If the child has both vocal and motor symptoms which last more than a year, the term Gilles de la Tourette syndrome or more commonly Tourette syndrome.

Symptoms (motor and vocal tics) in Tourette syndrome can be pretty bizarre.
Most extreme and distressing are involuntary cursing (coprolalia) and obscene gestures (copropraxia). Suffice it to say that any involuntary repetitive activities or vocalizations in children between 2 and 14 or so deserve consideration for Tourette syndrome.

A significant percentage of children with Tourette syndrome show signs of attention deficit disorder as well. Because treatment of ADD with stimulants such as methylphenidate (Ritalin¨) may possibly initiate or worsen tics, and perhaps may bring on full-blown Tourette syndrome, any new or worsening tics in a child on ADD medication must be immediately reported to the childs physician.

Long term studies of the natural history of Tourette syndrome show the average age of onset as about five to six years old. Tic severity peaks around 10 years of age, with a range between 8 and 12 years. About one fifth of patients with Tourette syndrome will have such severe problems that school is interfered with or impossible. Almost all patients get better with time, and by age 18, half of affected children are tic-free, and nine of ten have only mild or no tics.

Nobody wants to make tics worse, but is there any way to make them better? While you can’t cure tics, you can take some easy steps to lessen their impact:

•Don’t focus on it. If you know you have a tic, forget about it. Concentrating on it just makes it worse.
•Avoid stress-filled situations as much as you can — stress only makes tics worse. So get your work done early and avoid the stress that comes with procrastination and last-minute studying.
•A tic? What tic? If a friend of yours has a tic, don’t call attention to it. Chances are your friend knows the tic is there. Pointing it out only makes the person think about it more.
•Get enough sleep. Being tired can makes tics worse. So make sure to get a full night’s rest!
•Let it out! Holding back a tic can just turn it into a ticking bomb, waiting to explode. Have you ever felt a cough coming on and tried to avoid it? Didn’t work out so well, did it? Chances are it was much worse. Tics are very similar.
In certain cases, tics are bad enough to interfere with someone’s daily life and medication may be prescribed.

Don’t let a little tic dictate who you are or how you act. Learning to live with and not pay attention to the tic will make you stronger down the road.

Treatment and recovery :-
Psychological support and counselling can be helpful for those with disruptive tics and cognitive behavioural therapy may help some people control their condition.

Medication is the most effective treatment in reducing the tic itself. However, the powerful drugs used (such as haloperidol, pimozide, fluphenazine and clonidine) tend to have unpleasant side-effects. So, while 70 per cent of those with Tourette have tried drugs, for example, many people prefer to manage without medication if possible.

*Don’t panic if your child develops a tic – most are mild and transient
*Most tics don’t interfere with life or school and don’t require treatment
*People taking stimulant drugs (for ADHD, for example) may develop tics but these should cease when the drug is stopped
*Stress can aggravate symptoms or simply make life harder – relaxation and biofeedback techniques may help.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/conditions/tics1.shtml
http://kidshealth.org/teen/diseases_conditions/brain_nervous/tics.html
http://www.drhull.com/EncyMaster/T/tics.html
Tics

http://en.wikipedia.org/wiki/Tic

 

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