Tourette Syndrome Flashcards
What is tourette syndrome?
neurodevelopment disorder manifested by motor and phonic tics
Etiology of tourette syndrome?
complex interaction btwn social and environmental factors and multiple genetic abnormalities
Epidemiology?
onset during childhood
M > W
often accompanied by psychiatric disorder: OCD, ADHD
Clinical manifestation?
Tics usually onset btwn 2-15 yrs, avg. 6 y/o
- sensation or urge to perform tic
- motor tics
- vocal tics
- ritualistic behavior
What are the different types of motor tics?
sudden brief movements
simple- eye blinking, facial grimacing, shoulder shrugging
complex-bizarre gait, kicking, jumping, scratching, etc.
echopraxia
copropraxia
What is echopraxia? copropraxia?
mimicking gestures
obscene gestures
What are the different types of vocal/phonic tics?
simple: sniffing, coughing, throat clearing
Coprolalia: obscene words
Echolalia: repetition of words
Palilalia: repeating phrase/work with increasing rapidity
PE for pt with Tourette syndrome?
normal except for presence of tics
Dx criteria for tourette syndrome?
- both motor and phonic tics
- tics many times/day
- severity of tics changes over time
- onset prior to 18 y/o
- tics must be witnessed by examiner
- not assoc. with another medical condition
What dx studies can you perform?
Brain MRI- if abn. on neuro exam
EEG- if need to eval for possible seizure activity
Tx for tourette syndrome?
tx comorbid psych disorder if present
CBT is 1st line for mild tics that are non-disabling
1st line therapy for moderate/severe tics?
Clonidine or Guanfacine
-alpha adrenergic agonists
What med is favored by specialists for moderate/severe tics?
Tetrabenazine
-antidopaminergic
What can you give to pts with severe tics unresponsive to other meds? What can be used for focal motor tics?
antipsychotics
Botulinum toxin injections
