Tourette syndrome


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Tourette syndrome

  1. 1. MR. JAYESH
  2. 2.  It is also called tic disorder. TS is a neurobehavioral disorder characterized bysudden, involuntary muscle movements (motortics) & vocalization (vocal tics). In some cases, the tics may include inappropriatewords. Symptoms, which may range from mild tosevere, usually appear before age 18. Motor tics tend to affect the head, trunk, orlimbs. They sometimes change in severity,frequency, & location. Verbal tics may involve awide variety of sounds, such as clients, yelps,barks, &
  3. 3.  Most TS sufferers gradually develop acombination of different motor & vocal tics.The tics may occur a few times or manytimes during the day. Tics may grow less frequent & severe duringadolescence or adulthood. In a few causes,they disappear completely afteradolescence. TS usually becomes apparent between ages2 & 15. Roughly one-half of
  4. 4.  The disorder is more common in males thanfemales. It affects from 0.1% to 1.0% of thegeneral population. Many people with TS have associatedbehavioral problems, such as obsessions &compulsions, inattention, hyperactivity, &impulsivity. Because of their odd behavior,they tend to experience distress &difficulties in social situations, in school, &on the
  5. 5.  The cause of TS is unknown. Many researcherssuspect the disorder is linked to abnormalities inneurotransmitters, because abnormal levels ofdopamine, serotonin, GABA, norepinephrine, &acetylcholine have been found in TS patients.Also, the basal ganglia & other brain regions showdecreased metabolic activity.Predisposing factors for TS may include: Genetic factors (in a few cases, TS may beinherited from both parents) Pregnancy & prenatal problems, such asemotional problems, stress during pregnancy, &severe nausea & vomiting during the firsttrimester of
  6. 6.  Facial tics, such as eye blinking, typically are thefirst sign of TS. The tics commonly begin aroundage 7, although some children as young as age 2have them. Over time, facial grimacing, neck orhead jerking, neck stretching, or body twisting &bending may occur. Tics tend to worsen during stress, excitement,boredom, or fatigue & to ease during relaxation,sleep, & when the person is absorbed in anactivity. although some people can suppress thetics for a short time, tension eventually builds &the tic
  7. 7.  Some people with TS periodically clear theirthroat, cough, sniff, grunt, snort, yelp, bark, orshout. They may touch other people excessivelyor repeat actions obsessively & unnecessarily. Afew engages in self-harming behaviors, such as lip& cheek biting & head banging. Other signs & symptoms may include: Coprolalia (swearing or using obscene language) Copropraxia (making obscene gestures) Low self-esteem Feeling of shame Obsessive thinking Compulsive
  8. 8.  TS is diagnosed clinically from patientobservation & evaluation of the familyhistory, which may reveal a familialpredisposition to TS. For diagnosis of TS, tics must be present forat least 1
  9. 9.  Treatment of TS may involve child & familypsychotherapy & possibly, medications. Psychotherapy promotes & maintains the child’sself-esteem & helps the patient & family learnabout: The nature of the disorder & how to mangesymptoms Stress management strategies, with focus onhow to best handle distress or crisis. Strategies for coping with the stigma of theillness, especially peer teasing. Social skills & ways to mange disagreements,anger, & conflict at school, at home, & in
  10. 10.  Most TS patients don’t require medication.However, some may take it when symptomsinterfere with their functioning. Specific drug therapy may involve one of threetypes of drugs: Low-dose antipsychotic agents, such as pimozide(orap), risperidone, & (for severe tics)haloperidol. SSRIs, such as fluoxetine, for patients who alsohave obsessive-compulsive disorder Clonidine, an antihypertensive
  11. 11.  Develop a relationships may be appropriate withthe child that fosters trust & acceptance. Teach him about the disorder & ways to mangesymptoms. Help him address behaviors that contribute toirritability & frustration. Explain to the child & family that stress tends toincrease tic frequency, whereas quiet activities(such as reading) can diminish the intensity oftics. If appropriate, recommend relaxation &biofeedback therapy. Encourage the child to express feelings aboutthe illness & the problems he
  12. 12.  Help him learn to cope with impulses, negativity,& unacceptable behaviors. Promote the child’s strengths & self-esteem. Address ways for him to stay positive abouthimself. Work with family members to decrease theirfocus on the child’s symptoms & to reducecritical comments. If he has difficulty in regular classes, help thefamily obtain information about specialeducation options as appropriate,
  13. 13.