Tourette syndrome (TS) is a genetically determined disorder of the nervous system characterized by numerous tics (uncontrollable, sudden, rapid and repetitive movements or sounds). Tourette syndrome usually begins in childhood and continues throughout life, although symptoms can be very varied and vary from person to person.
Symptoms
Tourette syndrome is characterized by core symptoms called tics, which are uncontrollable, sudden, rapid and repetitive movements or sounds. These symptoms are very individual and can vary from mild to severe. Also, tics can be divided into motor and phonation, which can be simple or complex.
Motor tics are rapid movements in one or more parts of the body. Simple motor tics may include blinking, head or shoulder jerking. Complex motor tics can be more complex and involve multiple parts of the body, such as performing various movements.
Phonic, or vocal, tics are the sounds that a person makes. Simple vocal tics can include coughing, sneezing, or snoring. Complex vocal tics can include repeating words or phrases, sometimes even using profanity or offhand remarks called coprolalia, although this is a less common symptom.
Many people with Tourette syndrome also experience temporary remissions, during which symptoms may decrease or disappear altogether. In addition, tics have been observed to worsen with stress, tension, fatigue, prolonged sitting, or inactivity. It's important to note that while tics can be managed for a short period of time, they cause significant stress in the long run.
Many people with Tourette syndrome also have other disorders, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, depression, and learning difficulties, which may include problems with language or math.
Causes of Tourette syndrome
Tourette syndrome is a genetically determined disorder, but its exact cause is unknown. Scientists believe that Tourette syndrome is caused by several genes, not all of which have yet been identified. In addition, environment and family history can affect the risk of Tourette syndrome.
Genetically, most studies show that Tourette syndrome is inherited in an autosomal dominant manner, with unequal penetrance and gender differences. This pattern of inheritance means that a child can inherit Tourette syndrome from one parent. In addition, men are more prone to the symptoms of Tourette syndrome than women. However, due to unequal penetrance, not all carriers of the genetic code actually develop symptoms.
In addition to genetic factors, environmental factors and family history can also affect the risk of Tourette syndrome. Some studies suggest that prenatal factors, such as maternal smoking during pregnancy, complications during childbirth, or premature birth, may increase the risk of Tourette syndrome.
Biologically, Tourette syndrome may be related to an imbalance of neurotransmitters such as dopamine, serotonin, and noradrenaline in the brain. Dopamine is particularly important because it is involved in the control of movements that can be disrupted in Tourette syndrome.
Tourette syndrome is a complex disorder caused by many factors, and further research is needed into how certain factors interact to cause this particular disorder.
Diagnostics
The diagnosis of Tourette's syndrome is based on clinical criteria, not laboratory tests. According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Tourette syndrome is diagnosed when:
At least one vocal tic and several motor tics occur, although not necessarily at the same time.
Tics begin before the age of 18.
Tics last longer than one year.
Tics cannot be explained by other medical conditions or medications.
Treatment
Treatment for Tourette syndrome depends on the severity of the symptoms and the individual needs of the patient. Treatment may include:
Drug therapy: Antipsychotics (eg haloperidol, risperidone), alpha adrenergics (eg guanfacine), botulinum toxin (to reduce tics), SSRIs (serotonin reuptake inhibitors) to treat OCD symptoms.
Psychotherapy: cognitive and behavioral therapy (CBT), exposure and response prevention therapy (EAPT), stress management training for tics.
Support and education: information about Tourette syndrome and its effects, including teaching independent living skills and improving social functioning.
Tourette syndrome is a complex disorder with a variety of symptoms. Although there are many treatment options for Tourette syndrome, it is important to understand that each patient's needs are individual. Continued research is important to better understand the causes of Tourette syndrome, develop advanced diagnostic tools, and develop more effective treatment strategies.
Sources of information:
Robertson, M. M. (2000). Tourette syndrome, associated conditions and the complexities of treatment. Brain, 123(3), 425-462.
Leckman, J. F. (2002). Tourette's syndrome. The Lancet, 360(9345), 1577-1586.
Spencer, T., Biederman, J., & Harding, M. (1998). Disentangling the overlap between Tourette’s disorder and ADHD. Journal of Child Psychology and Psychiatry, 39(7), 1037-1044.
Robertson, M. M. (2006). Attention deficit hyperactivity disorder, tics and Tourette’s syndrome: the relationship and treatment implications. A commentary. European Child & Adolescent Psychiatry, 15(1), 1-11.
State, M. W., & Pauls, D. L. (2015). The genetics of Tourette syndrome. Current neurology and neuroscience reports, 5(4), 287-294.
Singer, H. S. (2005). Tourette's syndrome: from behaviour to biology. The Lancet Neurology, 4(3), 149-159.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Verdellen, C., Van De Griendt, J., Hartmann, A., & Murphy, T. (2011). European clinical guidelines for Tourette syndrome and other tic disorders. European Child & Adolescent Psychiatry, 20(4), 155-171.
Piacentini, J., Woods, D. W., Scahill, L., Wilhelm, S., Peterson, A. L., Chang, S., ... & Walkup, J. T. (2010). Behavior therapy for children with Tourette disorder: a randomized controlled trial. Jama, 303(19), 1929-1937.
Conelea, C. A., & Woods, D. W. (2008). The influence of contextual factors on tic expression in Tourette's syndrome: a review. Journal of Psychosomatic Research, 65(5), 487-496.
# tureto sindromas # ocd # adhd # sutrikimas
