Movement disorders 3

Question 1

a neurological disorder manifested by multiple motor and phonic tics

Answer 1

tourette syndrome

Question 2

what is the average age of onset of tourette syndrome?

Answer 2

6 years old, typically btwn 2-15 years

Question 3

sudden, brief intermittent movement or utterance

Answer 3

tic

Question 4

name some examples of simple tics.

Answer 4

blinking, grimacing, head thrusting, sniffling, shoulder shrugging

Question 5

what type of tic usually comes first in a complex tic?

Answer 5

motor tic

Question 6

imitation of the movement of others

Answer 6

echopraxia

Question 7

involuntary obscene speech

Answer 7

coprolalia

Question 8

repetition of others’ speech

Answer 8

echolalia

Question 9

palilalia

Answer 9

repetition of words or phrases

Question 10

there’s a comorbidity rate of 60% for ADHD in patients with tourette syndrome. T or F?

Answer 10

true

Question 11

Typically imaging isn’t necessary in patients with tourette syndrome unless there is an abnormal neurologic exam. If there was imaging, what would be the only abnormality observed?

Answer 11

volume loss in caudate nucleus on a volumetric MRI lol

Question 12

name the clinical diagnostic criteria to diagnose tourette syndrome.

Answer 12

• both multiple motor tics and > or equal to 1 phonic tics must be present at some point during the illness
• tics must occur many times a day, nearly every day, or intermittently for at least 1 year
• onset of tics is before age 21
• tics must change over time (ex. location, frequency, number, type, severity)
• can’t be better explained by another medical condition
• tics witnessed by a reliable examiner or recorded

Question 13

what is the main differentiating factor between Tourette syndrome and sporadic tic disorders?

Answer 13

sporadic tic disorders are characterized by tics that are either vocal or motor, but not both

Question 14

name two types of habit reversal training (HRT) used to treat Tourette syndrome?

Answer 14

tic-awareness training and competing-response training

Question 15

Which type of training involves having the patient learn to recognize early signs that precede the onset of a tic?

Answer 15

tic-awareness training

Question 16

which type of training involves teaching the patient to perform a voluntary movement that is incompatible with the particular type of tic?

Answer 16

competing-response training

Question 17

which medications that are used to treat Tourette syndrome can results in tardive dyskinesia as a side effect?

Answer 17

antidopaminergic medications such as haldol (antipsychotic) and pimozide

Question 18

which medication is used to treat patients with Tourette syndrome who also have ADHD?

Answer 18

clonidine (Catapres) or Guanfacine (Intuniv)

Question 19

What is the treatment for patients with Tourette syndrome + OCD?

Answer 19

behavioral therapy + SSRI, ex. fluoxetine (prozac) 20 mg PO daily, if no response to this then –> 2nd generation antipsychotic like seroquil

Question 20

prognosis of Tourette syndrome

Answer 20

resolves in up to half of patients by age 18