Tourette Syndrome
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While TS+ is common in patients referred to clinics and may challenge clinical skills, those with TS are increasingly being identified and need help in putting their symptoms in perspective.
Gilles de la Tourette syndrome (GTS) is a complex neuropsychiatric disorder characterized by multiple motor and phonic tics. We identified a male patient with GTS and other anomalies. It was determined that he carried a de novo duplication of the long arm of chromosome 7 [46,XY,dup(7)(q22.1-q31.1)]. Further molecular analysis revealed that the duplication was inverted. The distal chromosomal breakpoint occurred between the two genetic markers D7S515 and D7S522, which define a region previously shown to be disrupted in a familiar case of GTS. Yeast and bacterial artificial chromosome clones spanning the breakpoints were identified by means of FISH analysis. To further characterize the distal breakpoint for a role in GTS, we performed Southern blot hybridization analysis and identified a 6.5-kb SacI junction fragment in the patient's genomic DNA. The DNA sequence of this fragment revealed two different breaks in 7q31 within a region of sim500 kb. IMMP2L, a novel gene coding for the apparent human homologue of the yeast mitochondrial inner membrane peptidase subunit 2, was found to be disrupted by both the breakpoint in the duplicated fragment and the insertion site in 7q31. The cDNA of the human IMMP2L gene was cloned, and analysis of the complete 1,522-bp transcript revealed that it encompassed six exons spanning 860 kb. The possible role of IMMP2L and several other candidate genes within the region of chromosomal rearrangement, including NRCAM, Leu-Rch Rep, and Reelin, is discussed. The 7q31 breakpoint interval has also been implicated in other neuropsychiatric diseases that demonstrate some clinical overlap with GTS, including autism and speech-language disorder.
Tics may be suppressed for a short time. Doing this causes additional strain on families because individuals suppressing their tics until returning home allow their full expression in the home environment.
Although the tics associated with TS can sometimes be frequent and severe, more often they are not. TS typically occurs in children who are of normal intellectual functioning, and who are aware of their often bizarre behaviors.
Jan Blacher, Exceptional Parent
Dr. Phil (Phillip Calvin McGraw) ran a segment on his January 17, 2006 television show titled Extreme Disorders, about Tourette's syndrome and Asperger's. His guests representing Tourette's -- Craig (with TS), accompanied by his fiancée Amy -- were composed, gracious, personable, charming, well-spoken and humorous. They could not have represented people with Tourette's better, both in character and in their responses to leading questions (that sometimes came across as negative and baiting) about life with severe tics and coprolalia. But, Dr. Phil repeatedly referred to both conditions (Tourette's and Aspergers) as extreme. He never mentioned that most people with Tourette Syndrome have mild symptoms, or that severe Tourette's disorder in adulthood is rare. Dr. Phil constantly turned his conversation to more sensationalized aspects and severe symptoms of both conditions (repeatedly emphasizing extreme anger and violence in Asperger's syndrome, and coprolalia in Tourette Syndrome -- never noting that it occurs in a small minority of persons with Tourette's). Craig and Amy saved the day, with their calm and compassionate demeanor and responses.
Tics are the result of impulsive and oppositional defending the partial breakthrough into the somatic realm of forbidden, unreleased impulses. Sexual impulses emanating from the core turn to rage when blocked by armor.
The case of SN, a male red squirrel (Sciurus vulgaris leucourus) of indeterminate age, was reported in detail by Potter. SN came from an extensive family with no apparent history of neurological or other disease.
Timothy Williams, Gareth Williams
Tourette Syndrome is an inherited, neurological disorder characterized by repeated and involuntary body movements (tics) and uncontrollable vocal sounds.
M.M. Robertson, J.S. Stern
Tourette Syndrome (TS), first described by Gilles de la Tourette, can be the most debilitating tic disorder and is characterized by multiform, frequently changing motor and phonic tics.
Ruth Dowling Bruun, Donald J. Cohen, James F. Leckman
Occupational Therapy is a profession that has emphasized the understanding of human behavior from a neurobiological viewpoint. Research has led us to a better understanding of what is taking place in the brain and how we can effect it.
Tics, echolalia, echopraxia, palilalia, and other repetitions, coprolalia
Dr. McKinlay himself has Tourette Syndrome, and is committed (devoted, that is!!) to improving the quality of life in people with Tourette and a variety of other disorders.
The story of Mozart's life informs us that he may have lived longer and given us still greater gifts if his father had loved him and accepted him unconditionally. It is this unconditional acceptance of all aspects of the child with TS, to include all his unruliness, irreverence, and wild behavior, that creates the soil in which his gifts will flower to their potential magnificence.
Ritualistic behaviors and repetitive thoughts have been extensively studied in the last years. The definitions of obsessive-compulsive disorder and Tourette syndrome emphasize the existence of a continuum of symptoms, with high prevalence in the general population. Neurobiological findings have implicated genetic and immunological factors in the etiology of these two disorders.
Marcos T. Mercadante et al
The neurobiological basis of Tourette's syndrome is reviewed for the purpose of presenting a clinically relevant account of the neuropsychology of the disorder for the clinician who is behaviorally oriented. The neuropathology and neuropsychological deficits typically found in Tourette's are reviewed, and a neuropsychological test battery is described that can be used to help characterize the clinical presentation of the disorder. Although Tourette's syndrome is ultimately diagnosed by behavioral criteria, characterizing the cognitive deficits (or lack thereof) associated with the disorder is integral to fully appreciating the challenges posed by the disorder in any given case. The variety of cognitive deficits associated with Tourette's is reviewed to show the importance of the neuropsychological evaluation in differential diagnostic, therapeutic, and prognostic decisions.
David C. Osmon, Jessica Smerz
While many TS individuals have benefited from nutritional supplementation (often along with dietary and/or allergy control), families tend to experience frustration and a lack of direction when confronting this issue.
Albert Robbins, Jon Pangborn
These results indicate that the rate of GTS in autism exceeds that expected by chance, and the combined rate (6.2%) is similar to the rates found in the smaller-scale study (8.1%).
Simon Baron-Cohen, Mortimore, Moriarty, Izaguirre, Robertson
In this study, we found no convincing association between the exacerbation of tic and OC symptoms and the occurrence of GABHS infections among an unselected group of patients with TS and/or OCD. Although a small number of exacerbations were preceded by GABHS infections, many others were not. Similarly, other patients experienced GABHS infections without any clear effect on their tic and OC symptom presentation.
Our findings indicate that there are limited relationships between representational mental state understanding, executive functions, and symptom severity in autism.
Robert M Joseph, Helen Tager-Flusberg
This case report illustrates how pharmacodynamic properties of drugs can complicate the treatment of neurologic disorders.
Beth Dubisar, Steven Stoner, Rintu Khan, Cynthia Farrar
A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs.
American Academy of Child and Adolescent Psychiatry
Low doses of tacrine hydrochloride reduced involuntary movements and vocalisations (motor and vocal tics), according to quantifiable measurements taken by investigators. In contrast, high doses did not work or could aggravate the symptoms.
Its mission is to identify the cause of, find the cure for and control the effects of TS. Members include many thousands of individuals with the disorder, their relatives and friends, doctors and allied professionals working in the field.
On this site, patients, their families, teachers, and clinicians can learn about Tourette's Syndrome, ADHD, OCD, Executive Dysfunction, Bipolar Disorder, autism spectrum disorders, 'rage attacks' and much more.
Tourette syndrome (TS) is characterized by multiple motor tics plus one or more vocal (phonic) tics, which characteristically wax and wane. It can no longer be considered the rare and bizarre syndrome that it was once thought to be. The concepts surrounding TS, and our understanding of it, are also becoming increasingly complex and, in some individuals, TS is now recognized to be associated with a wide variety of associated behaviours and psychopathologies. It is suggested that TS is heterogeneous from a variety of standpoints including clinical presentation and psychopathology, and thus neuropharmacological responses and possibly even aetiological and genetic mechanisms. In this paper, mention is made of recent findings in epidemiology and genetics, highlighting the complexities of the disorder; these have been chosen because findings in both areas have clinical and management implications. The literature on the clinical manifestations, associated behaviours, psychopathology (and/or comorbid conditions) and management, in particular, is reviewed in detail.
In this paper, mention is made of recent findings in epidemiology and genetics, highlighting the complexities of the disorder; these have been chosen because findings in both areas have clinical and management implications. The literature on the clinical manifestations, associated behaviours, psychopathology (and/or comorbid conditions) and management, in particular, is reviewed in detail.
Tourette's disorder or Tourette's syndrome (TS) as it is frequently called, is a neurologic syndrome. The essential feature of TS are multiple tics that are sudden, rapid, recurrent, non-rhythmic, stereotypical, purposeless movements or vocalizations.
National Alliance for the Mentally Ill
Tics are the manifestations of Tourette's syndrome. Unlike the common childhood tics that usually vanish within a year, the tics of Tourette's last and last. Tourette Tics can be Motor Tics, Vocal Tics, Simple Tics and / or Complex Tics.
Once dismissed as a behavior flaw, Tourette's syndrome is now known to be an inherited neurological disease. New research is mapping the chemical origin of the disorder.
The significance of this case is that it clearly shows a relationship between Tourette syndrome and allergy/environmental sensitivities (which we have also found to hold true with some cases of autism, ADD/ADHD, and psychosis).
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