Pseudo-tics in Tourette Syndrome
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We describe two patients with Tourette syndrome who also had pseudo-tics. The psychogenic movements resolved in both children when the stressful issues in their lives were addressed. It is important to differentiate psychogenic symptoms from tics and compulsions in children with Tourette syndrome in order to avoid unnecessary medication and allow appropriate therapy. (J Child Neurol 1994;9:50-51).Tics and Tourette's syndrome are common hyperkinetic movement disorders seen mostly in the pediatric age group. Tics are defined as sudden, rapid, recurrent, nonrhythmic motor movements or vocalization, generally preceded by urge. Tourette's syndrome is defined as the presence of both motor and phonic tics for more than 1 year in patients with onset less than 18 years old. Most of these hyperkinetic movement disorders improve in adulthood. This review emphasizes the clinical pearls in the diagnosis and distinguishing it from other movement disorders. The treatment ranges from behavioral therapies, medical management, and also surgical treatment such as deep brain stimulation that is limited to refractory patients.
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Tic disorder
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We describe two patients with Tourette syndrome who also had pseudo-tics. The psychogenic movements resolved in both children when the stressful issues in their lives were addressed. It is important to differentiate psychogenic symptoms from tics and compulsions in children with Tourette syndrome in order to avoid unnecessary medication and allow appropriate therapy. (J Child Neurol 1994;9:50-51).
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Comprehensive behavioral intervention for tics (CBIT) administered individually is an effective treatment for tics. However, the effectiveness of CBIT administered in groups for adults with Tourette syndrome and chronic tic disorders has not been investigated yet. This pilot study examined the effectiveness of group‐based CBIT with respect to reduction of tic severity and tic‐related impairment, as well as improvement of tic‐related quality of life. Data from 26 patients were included in the intention‐to‐treat analyses. The Yale Global Tic Severity Scale was used to assess total tic severity and tic‐related impairment. The Gilles de la Tourette – Quality of Life Scale was used to assess tic‐related quality of life. These measures were administered at three points in time: at pretreatment, posttreatment, and 1‐year follow‐up. The results showed a significant reduction of total tic severity from pretreatment to 1‐year follow‐up, with larges effect sizes. Tic‐related impairment and tic‐related quality of life also improved significantly, although the effect sizes were smaller. Motor tics showed a stronger reduction than vocal tics. Additional analysis revealed that all change was achieved during treatment and that this effect was maintained from posttreatment to 1‐year follow‐up. The results of this study indicate that group‐based CBIT is a promising treatment for tics.
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Tics, patterned movements distinct from stereotypies, myoclonus, and other hyperkinetic movements, are quite common in children, particularly among those with developmental and psychiatric disorders. Thus, tics can indicate the presence of atypical neurodevelopment or broader difficulties with cognition or mood. Tics are also the cardinal feature of Tourette syndrome, a childhood-onset neurobehavioral disorder characterized by a chronic inability to suppress or an urge to perform patterned, repetitive movements. Patients with Tourette syndrome most commonly have, in addition to tics, symptoms of inattention, hyperactivity, obsessiveness, or anxiety. Achieving the most effective treatment of a child with tics is contingent on proper diagnosis of the movement disorder and thorough assessment for other problems, followed by consideration of both nonpharmacologic and pharmacologic interventions for any and all symptoms interfering with the child's function and quality of life. This review focuses primarily on the diagnosis and medical treatment of tics in children and adolescents with Tourette syndrome. (J Child Neurol 2006;21:690—700; DOI 10.2310/ 7010.2006.00161).
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Objective To observe the curative effect of stereotactic pallidotomy with radiofrequency on sensory tics in Tourette syndrome. Methods The stereotactic lesioning of unilateral posteroventral globus pallidus with radiofrequency was performed under the guidance of microerectrode recording in 22 patients with refractory Tourette syndrome. And tic severty and sensory tics were accessed by Yale global tic severity scale (YGTSS) and premonitory sensory phenomenon questionnaire. Results There were various types of sensory tics in 18 of 22 patients with Tourette syndrome (81.8%). The sensory tics occurred in the heads and faces in 13 of 18 patients with various types of sensory tics (72.2%). The frequency of sensory tics was significantly reduced after the pallidotomy as compared to that before pallidotomy. There was significant improvement in the Tourette symptom severity scale of th side opposite to the lesioning after the pallidotomy as compared to that before the pallidotomy (P0.01). The improvement in motor tic scale was more signigicant. Conclusions Sensory tics is a common symptom in the patients with Tourette syndrome. Pallidotomy produces a significant and short term reduction of tic severity in the patients with refractory Tourette syndrome. The long-term effect of pallidotomy on sensory tics should be further studied in the patients with refractory Tourette syndrome.
Pallidotomy
Stereotactic surgery
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