Tourette syndrome
Tourette syndrome is a common neuropsychiatric disorder with onset in childhood, characterized by multiple motor tics and at least one vocal(phonic) tic. These tics an unwanted urge or sensation in the affected muscles. Some common tics are eye blinking, coughing, throat clearing, sniffing, and facial movements. Tourette's does not adversely affect intelligence or life expectancy.
Tourette's syndrome is a problem with the nervous system that causes people to make sudden movements or sounds, someone with Tourette's might blink or clear their throat over and over again. Some people may blurt out words they don't intend to say. Treatment can control tics, but some people don't need any unless their symptoms really bother them.
About 100,000 Americans have full-blown Tourette's syndrome, but more people have a milder form of the disease. It often starts in childhood and more boys than girls get it. Symptoms often get better as children grow up. For some people, they go away completely.
Causes:
Tourette's has been linked to different parts of the brain, including an area called the basal ganglia, which helps control body movements. The difference there may affect nerve cells and the chemicals that carry messages between them. Researchers think the trouble in this brain network may play a role in Tourette's. Don't know exactly what causes these problems in the brain, but genes probably play a role. It's likely that there is more than one cause. People who have family members with Tourette's are more likely to get it themselves. But people in the same family may have different symptoms.
Pathophysiology:
The exact mechanism affecting the inherited vulnerability to Tourette's has not been established and the precise cause 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.
After 2010, the central role of histamine and the H3-receptor came into focus on the pathophysiology of Tourette syndrome. Also, the striatum is involved because of histamine and the H3- receptor are key modulators of striatal circuitry. Studies suggest that a reduced level of histamine in the H3- receptor is an important link in the neurotransmitters, which causes the tics.
Symptoms:
The main symptom is tics. Some are so mild they are not even noticeable. Others happen often and are obvious. Stress, excitement, or being sick or tired can make them worse. The more severe ones can be embarrassing and can affect your social life or work.
They are two types of tics.
Motor tics involve movement. they include:
. Arm or head jerk
. Blinking
. Make a face
. Mouth twitching
. Shoulder shrugging
Vocal tics include:
. Barking or yelping.. Clearing your throat
. Coughing.
. Grunting
. Repeating what someone else says
. Shouting
. Sniffing
. Swearing
Tics can be simple or complex. A simple tic affects one or just a few parts of the body, like blinking the eyes or making a face. A complex one involves many parts of the body or saying words. Jumping and swearing are examples.
Before a motor tic, you may get a sensation that can feel like a tingle or tension. The movement makes the sensation go away. You might be able to hold your tics back for a little while, but you probably can't stop them from happening. Aren't sure why, but about half of people with Tourette's also have symptoms of attention deficit hyperactivity disorder (ADHD). You may have trouble paying attention, sitting still, and finishing tasks.
Tourette's can also cause problems with:
. Anxiety
. Learning disabilities such as dyslexia
. Obsessive-compulsive disorders(OCD)- thoughts and behaviors you can't control, like washing your hands over and over again.
Diagnosed:
Tourette syndrome is a diagnosis that doctors make after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions can also help doctors arrive at a diagnosis. Common tics are not often misdiagnosed by knowledgeable clinicians. However, atypical symptoms or atypical presentations (for example, the onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. There are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging (MRI) or computerized tomography(CT), electroencephalogram(EEG) studies, or certain blood test may be used to rule out other conditions that might be confused with Tourette syndrome when the history or clinical examination is atypical.
It is not common for patients to obtain a formal diagnosis of Tourette syndrome only after symptoms have been present for some time. The reasons for this are many, for families and physicians unfamiliar with Tourette syndrome, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about Tourette syndrome from others.
Prognosis:
Regardless of symptoms severity, individuals with Tourette's have a normal lifespan. 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 learning disabilities. The severity of tics early in life does not predict tic severity in later life, and the prognosis is generally favorable, although there is no reliable of predicting the outcome for a particular individual. 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 an 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 tic severity and the onset of puberty, in contrast with the popular belief that tics increase at puberty.
Epidemiology:
Tourette syndrome is found among all social, racial and ethnic groups and has been reported in all parts of the world it is three to four times more frequent among males than females. As children pass through adolescence, about one-quarter become tic-free, almost one-half see their tics diminish to a minimal or mild, and less than one-quarter have persistent tics. Only 5 to 14% of adults experience worse tics in adulthood than in childhood.
Up to 1% of the overall population experiences tic disorders, including chronic tics and transient tics of childhood. Chronic tics affect 5% of children, and transient tics affect up to 20%, prevalence rates in special education populations are higher. the reported prevalence of Tourette syndrome varies according to the source, age, and sex of the sample, the ascertainment procedures; and diagnostic system, with a range, reported between 4% and 3.8% for children ages 5 to 18. Robertson(2011) says that 1% of school-age children have Tourette syndrome.
History:
In 1885, Gilles de la Tourette published an account in the study of a Nervous Affliction describing nine persons with "convulsive tic disorder", concluding that a new clinical category should be defined. The eponym was later bestowed by Charcot after on behalf of Gilles de la Tourette.
Little progress was made over the next century in explaining or treating tics, and a psychogenic view prevailed well into 20th century. The possibility that movement disorders, including Tourette syndrome, might have an organic origin was raised when an encephalitis epidemic from 1918-1926 led to a subsequent epidemic of tic disorders.
Management:
Knowledge, education, and understanding are uppermost in management plans for tic disorders. The management of the symptoms of Tourette's may include pharmacological, behavioral and psychological therapies. Because children with tics often present to physicians when their tics are most severe, and because of the waxing and waning nature of tics, it is recommended that medication not is started immediately or changed often. Frequently the tics subside with explanation, reassurance, understanding of the condition and a supportive environment. When medication is used, the goal is not to eliminate symptoms. It should be used at the lowest possible dose that manages symptoms for which they were prescribed.
Cognitive Behavioral Therapy:
Is a useful treatment when OCD is present, and there is increasing evidence supporting the use of the habit reversal(HRT) in the treatment of tics. There is evidence that HRT reduces tic severity, but there are methodological limitations in the studies, and a need for, more trained specialists and better large-scale studies.
Relaxation techniques:
Such as exercise, yoga or meditation, may be useful in relieving the stress that may aggravate tics, but the majority of behavioral (such as relaxation training and biofeedback, with the exception of habit reversal) have not been systematically evaluated and are not empirically supported therapies for Tourette's. Deep brain stimulation has been used to treat adults with severe Tourette's that does not respond to conventional treatment, but it is regarded as an invasive, experimental procedure that is unlikely to become widespread.
Homeopathic Rubrics for Tourette's syndrome:
. Mind; GESTURES, makes, motions, involuntary, of the:
. Mind; GESTURES, makes, motions, involuntary, face, to the
. Mind; GESTURES, makes, motions, involuntary, of the, folding hands
. Mind; GESTURES, makes, motions, involuntary, of the, hasty
. Mind; GESTURES, makes, motions, involuntary, of the, head, to the
. Mind; GESTURES, makes, motions, involuntary, of the, knitting, as if
. Mind; GESTURES, makes, motions, involuntary, of the, lifting up hands
. Mind; GESTURES, makes, motions, involuntary, of the, spinning together
. Mind; GESTURES, makes, motions, involuntary, of the, throwing about
. Mind; GESTURES, makes, motions, involuntary, of the, throwing about, overhead
. Mind; GESTURES, makes, motions, involuntary, of the, waving in the air
. Mind; GESTURES, makes, motions, involuntary, of the
. Mind; HURRY; movements, in
. Mind; restlessness, nervousness;
. Mind; restlessness, nervousness; from conversation
. Mind; restlessness, nervousness; in children
. Eye; Close, involuntary
. Eye; Close, involuntary, left, with a headache
. Eye; Close, involuntary, walking in open air, while
. Eye; MOVEMENT, eyeballs involuntary
. Eye, STARING, general involuntary
Homeopathic remedies for Tourette's syndrome:
Hyoscyamus Niger:
Extremities, picking at bedclothes, play with hand, reaches out for things. Epileptic attacks ending in deep sleep, spasms and convulsions. Cramps in calves and toes. Child sobs and cries without waking.
Stramonium:
Extremities: Graceful, rhythmic motions. Convulsions of upper extremities and of isolated groups of muscles. Chorea; spasms partial, constantly changing(tetanus, trismus). Violent pain in left hip. Trembling, twitching of tendons. staggering gait(locomotor ataxia).
Nux-Vom:
Eys, photophobia, worse in the morning. Smarting dry sensation in the inner canthi. Infra-orbital neuralgia, with watering of eyes. Optic.
Opium:
Face: Red, bloated, swollen, dark, suffused, hot. Looks intoxicated, besotted. Spasmodic facial twitching especially at the corners of the mouth. Veins of face distended. Hanging down to lower jaw. Distorted.
Agaricus:
Eyes: Reading difficult, as type seems to move, swim. Vibrating specters. Diplopia, dim and flickering. Asthenopia from the prolonged strain, spasm of accommodation. Twitching of lids and eyeballs. Margins of lids red, itch, burn and agglutinate. Inner canthi very red.
Face: Facial muscles feel stiff; twitch; face itches and burns. Lancinating, tearing pain in cheeks, as of splinters. Neuralgia, as if cold needles ran through the nerves or sharp pieces of ice touched them.
Tourette syndrome is a common neuropsychiatric disorder with onset in childhood, characterized by multiple motor tics and at least one vocal(phonic) tic. These tics an unwanted urge or sensation in the affected muscles. Some common tics are eye blinking, coughing, throat clearing, sniffing, and facial movements. Tourette's does not adversely affect intelligence or life expectancy.
Tourette's syndrome is a problem with the nervous system that causes people to make sudden movements or sounds, someone with Tourette's might blink or clear their throat over and over again. Some people may blurt out words they don't intend to say. Treatment can control tics, but some people don't need any unless their symptoms really bother them.
About 100,000 Americans have full-blown Tourette's syndrome, but more people have a milder form of the disease. It often starts in childhood and more boys than girls get it. Symptoms often get better as children grow up. For some people, they go away completely.
Causes:
Tourette's has been linked to different parts of the brain, including an area called the basal ganglia, which helps control body movements. The difference there may affect nerve cells and the chemicals that carry messages between them. Researchers think the trouble in this brain network may play a role in Tourette's. Don't know exactly what causes these problems in the brain, but genes probably play a role. It's likely that there is more than one cause. People who have family members with Tourette's are more likely to get it themselves. But people in the same family may have different symptoms.
Pathophysiology:
The exact mechanism affecting the inherited vulnerability to Tourette's has not been established and the precise cause 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.
After 2010, the central role of histamine and the H3-receptor came into focus on the pathophysiology of Tourette syndrome. Also, the striatum is involved because of histamine and the H3- receptor are key modulators of striatal circuitry. Studies suggest that a reduced level of histamine in the H3- receptor is an important link in the neurotransmitters, which causes the tics.
Symptoms:
The main symptom is tics. Some are so mild they are not even noticeable. Others happen often and are obvious. Stress, excitement, or being sick or tired can make them worse. The more severe ones can be embarrassing and can affect your social life or work.
They are two types of tics.
Motor tics involve movement. they include:
. Arm or head jerk
. Blinking
. Make a face
. Mouth twitching
. Shoulder shrugging
Vocal tics include:
. Barking or yelping.. Clearing your throat
. Coughing.
. Grunting
. Repeating what someone else says
. Shouting
. Sniffing
. Swearing
Tics can be simple or complex. A simple tic affects one or just a few parts of the body, like blinking the eyes or making a face. A complex one involves many parts of the body or saying words. Jumping and swearing are examples.
Before a motor tic, you may get a sensation that can feel like a tingle or tension. The movement makes the sensation go away. You might be able to hold your tics back for a little while, but you probably can't stop them from happening. Aren't sure why, but about half of people with Tourette's also have symptoms of attention deficit hyperactivity disorder (ADHD). You may have trouble paying attention, sitting still, and finishing tasks.
Tourette's can also cause problems with:
. Anxiety
. Learning disabilities such as dyslexia
. Obsessive-compulsive disorders(OCD)- thoughts and behaviors you can't control, like washing your hands over and over again.
Diagnosed:
Tourette syndrome is a diagnosis that doctors make after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions can also help doctors arrive at a diagnosis. Common tics are not often misdiagnosed by knowledgeable clinicians. However, atypical symptoms or atypical presentations (for example, the onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. There are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging (MRI) or computerized tomography(CT), electroencephalogram(EEG) studies, or certain blood test may be used to rule out other conditions that might be confused with Tourette syndrome when the history or clinical examination is atypical.
It is not common for patients to obtain a formal diagnosis of Tourette syndrome only after symptoms have been present for some time. The reasons for this are many, for families and physicians unfamiliar with Tourette syndrome, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about Tourette syndrome from others.
Prognosis:
Regardless of symptoms severity, individuals with Tourette's have a normal lifespan. 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 learning disabilities. The severity of tics early in life does not predict tic severity in later life, and the prognosis is generally favorable, although there is no reliable of predicting the outcome for a particular individual. 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 an 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 tic severity and the onset of puberty, in contrast with the popular belief that tics increase at puberty.
Epidemiology:
Tourette syndrome is found among all social, racial and ethnic groups and has been reported in all parts of the world it is three to four times more frequent among males than females. As children pass through adolescence, about one-quarter become tic-free, almost one-half see their tics diminish to a minimal or mild, and less than one-quarter have persistent tics. Only 5 to 14% of adults experience worse tics in adulthood than in childhood.
Up to 1% of the overall population experiences tic disorders, including chronic tics and transient tics of childhood. Chronic tics affect 5% of children, and transient tics affect up to 20%, prevalence rates in special education populations are higher. the reported prevalence of Tourette syndrome varies according to the source, age, and sex of the sample, the ascertainment procedures; and diagnostic system, with a range, reported between 4% and 3.8% for children ages 5 to 18. Robertson(2011) says that 1% of school-age children have Tourette syndrome.
History:
In 1885, Gilles de la Tourette published an account in the study of a Nervous Affliction describing nine persons with "convulsive tic disorder", concluding that a new clinical category should be defined. The eponym was later bestowed by Charcot after on behalf of Gilles de la Tourette.
Little progress was made over the next century in explaining or treating tics, and a psychogenic view prevailed well into 20th century. The possibility that movement disorders, including Tourette syndrome, might have an organic origin was raised when an encephalitis epidemic from 1918-1926 led to a subsequent epidemic of tic disorders.
Management:
Knowledge, education, and understanding are uppermost in management plans for tic disorders. The management of the symptoms of Tourette's may include pharmacological, behavioral and psychological therapies. Because children with tics often present to physicians when their tics are most severe, and because of the waxing and waning nature of tics, it is recommended that medication not is started immediately or changed often. Frequently the tics subside with explanation, reassurance, understanding of the condition and a supportive environment. When medication is used, the goal is not to eliminate symptoms. It should be used at the lowest possible dose that manages symptoms for which they were prescribed.
Cognitive Behavioral Therapy:
Is a useful treatment when OCD is present, and there is increasing evidence supporting the use of the habit reversal(HRT) in the treatment of tics. There is evidence that HRT reduces tic severity, but there are methodological limitations in the studies, and a need for, more trained specialists and better large-scale studies.
Relaxation techniques:
Such as exercise, yoga or meditation, may be useful in relieving the stress that may aggravate tics, but the majority of behavioral (such as relaxation training and biofeedback, with the exception of habit reversal) have not been systematically evaluated and are not empirically supported therapies for Tourette's. Deep brain stimulation has been used to treat adults with severe Tourette's that does not respond to conventional treatment, but it is regarded as an invasive, experimental procedure that is unlikely to become widespread.
Homeopathic Rubrics for Tourette's syndrome:
. Mind; GESTURES, makes, motions, involuntary, of the:
. Mind; GESTURES, makes, motions, involuntary, face, to the
. Mind; GESTURES, makes, motions, involuntary, of the, folding hands
. Mind; GESTURES, makes, motions, involuntary, of the, hasty
. Mind; GESTURES, makes, motions, involuntary, of the, head, to the
. Mind; GESTURES, makes, motions, involuntary, of the, knitting, as if
. Mind; GESTURES, makes, motions, involuntary, of the, lifting up hands
. Mind; GESTURES, makes, motions, involuntary, of the, spinning together
. Mind; GESTURES, makes, motions, involuntary, of the, throwing about
. Mind; GESTURES, makes, motions, involuntary, of the, throwing about, overhead
. Mind; GESTURES, makes, motions, involuntary, of the, waving in the air
. Mind; GESTURES, makes, motions, involuntary, of the
. Mind; HURRY; movements, in
. Mind; restlessness, nervousness;
. Mind; restlessness, nervousness; from conversation
. Mind; restlessness, nervousness; in children
. Eye; Close, involuntary
. Eye; Close, involuntary, left, with a headache
. Eye; Close, involuntary, walking in open air, while
. Eye; MOVEMENT, eyeballs involuntary
. Eye, STARING, general involuntary
Homeopathic remedies for Tourette's syndrome:
Hyoscyamus Niger:
Extremities, picking at bedclothes, play with hand, reaches out for things. Epileptic attacks ending in deep sleep, spasms and convulsions. Cramps in calves and toes. Child sobs and cries without waking.
Stramonium:
Extremities: Graceful, rhythmic motions. Convulsions of upper extremities and of isolated groups of muscles. Chorea; spasms partial, constantly changing(tetanus, trismus). Violent pain in left hip. Trembling, twitching of tendons. staggering gait(locomotor ataxia).
Nux-Vom:
Eys, photophobia, worse in the morning. Smarting dry sensation in the inner canthi. Infra-orbital neuralgia, with watering of eyes. Optic.
Opium:
Face: Red, bloated, swollen, dark, suffused, hot. Looks intoxicated, besotted. Spasmodic facial twitching especially at the corners of the mouth. Veins of face distended. Hanging down to lower jaw. Distorted.
Agaricus:
Eyes: Reading difficult, as type seems to move, swim. Vibrating specters. Diplopia, dim and flickering. Asthenopia from the prolonged strain, spasm of accommodation. Twitching of lids and eyeballs. Margins of lids red, itch, burn and agglutinate. Inner canthi very red.
Face: Facial muscles feel stiff; twitch; face itches and burns. Lancinating, tearing pain in cheeks, as of splinters. Neuralgia, as if cold needles ran through the nerves or sharp pieces of ice touched them.
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