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  • Tourette Syndrome—Child

    (TS—Child)

    Definition

    Tourette syndrome (TS) is a type of tic disorder. Tics are sudden muscle movements or vocal sounds that can range from mild to severe in how disrupting they are. TS, a neurological condition, is usually diagnosed during childhood.

    Causes

    TS may be a genetic condition, passed from parents to children. This is still being studied. TS may also be linked to problems with dopamine levels, a chemical in the brain that sends signals to neurons.
    Genetic Material
    Chromosome DNA
    TS may be inherited through genes, which make up DNA.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    Risk factors include:

    Symptoms

    Symptoms can range from mild to severe. They can occur suddenly, and the length of time they last can vary. Tics may temporarily decrease with concentration or distraction. During times of stress, they may occur more often.
    Tics can be muscle movements (motor tics) or vocal sounds (vocal tics). They can also be characterized as simple or complex. Here are some common examples:
      Motor tics
      • Simple—eye blinking, facial grimacing, head jerking, arm or leg thrusting
      • Complex—jumping, smelling, touching things or other people, twirling around
      Vocal tics
      • Simple—throat clearing, coughing, sniffing, grunting, yelping, barking
      • Complex—saying words or phrases that do not make sense in a given situation, saying obscene or socially unacceptable words (called coprolalia)
    Your child may also have other related conditions, such as:

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will also be done. In some cases, the doctor may order imagining tests (eg, MRI scan , PET scan ) to rule out other disorders. These tests are usually not needed. Your child will probably be referred to a mental health expert. This person will evaluate your child.

    Treatment

    Work with the doctor to create a treatment plan that is right for your child. Options include:

    Education and Counseling

    One important part of treatment is for the child and his family to learn about this syndrome. It is also helpful if the child’s teachers, classmates, and friends understand the condition.
    Your child may also benefit from behavior therapy. This can include doing relaxation techniques and self-monitoring. A technique known as “habit reversal therapy” and other behavioral treatments have proven helpful for some children.

    Medication

    In most cases, medicine is not needed to treat TS. If tics are severe and disrupt your child’s life, medicines may be recommended to reduce symptoms. Your child may also need to take medicine to treat other conditions, like ADHD. If medicine is ineffective or otherwise not right for your child, several experimental non-drug treatments have shown promise. Among these are magnetic brain stimulation and—for very severely affected children—deep brain stimulation.

    Prevention

    There is no known way to prevent TS.

    RESOURCES

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

    Tourette Syndrome Association http://www.tsa-usa.org/

    CANADIAN RESOURCES

    Tourette Syndrome Association of Ontario http://www.tourettesyndromeontario.ca/

    Tourette Syndrome Foundation of Canada http://www.tourette.ca/

    References

    Bestha DP, Jeevarakshagan S, Madaan V. Management of tics and Tourette's disorder: an update. Expert Opin Pharmacother. 2010;11(11):1813-1822.

    Children’s Hospital Boston. Tourette’s syndrome. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1761/mainpageS1761P0.html . Accessed July 13, 2010.

    Children’s Hospital of Wisconsin. Tourette’s disorder (TD). Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/22112/Nav/1/router.asp . Accessed July 13, 2010.

    Cincinnati Children’s Hospital Medical Center. Tourette Syndrome and Medications. Cincinnati Children’s Hospital Medical Center website. Available at: http://www.cincinnatichildrens.org/health/info/neurology/diagnose/tics-ts-meds.htm . Accessed July 13, 2010.

    DynaMed Editorial Team. Tourette syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 24, 2010. Accessed July 13, 2010.

    Franklin SA, Walther MR, Woods DW. Behavioral interventions for tic disorders. Psychiatr Clin North Am. 2010;33(3):641-655.

    Rosenblum L. Tourette syndrome. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 12, 2009. Accessed July 13, 2010.

    Schub T. Tourette’s syndrome. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated April 16, 2010. Accessed July 13, 2010.

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