Presentation
Abstract Although tics are considered the hallmark of Tourette syndrome, arguably tics may not be the only or primary presenting symptom. [ncbi.nlm.nih.gov]
However, even when tics are simple jerks, more complex forms of tics may also be present, allowing one to establish the diagnosis by "the company it keeps." [web.archive.org]
Respiratoric
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Nasal Irritation
Certain behaviors (eg, nose picking, which may initially arise as a response to dry nasal membranes and nasal irritation or itching) can later develop into a cycle that is difficult to break. [emedicine.medscape.com]
Ears
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Hearing Impairment
impairment or other sensory deficits Consultation with a developmental-behavioral pediatrician, a child psychologist, or a child psychiatrist may be indicated. [emedicine.medscape.com]
Eyes
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Oculogyric Spasm
The exceptions are (1) opsoclonus (dancing eyes), which is a form of myoclonus, (2) ocular myoclonus (rhythmic vertical oscillations at a rate of 2 Hz) that often accompanies palatal myoclonus, and (3) oculogyric spasms (a sustained deviation of the eyes [web.archive.org]
Musculoskeletal
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Muscle Twitch
Unlike tics, the majority of muscle twitches are isolated occurrences, not repeated actions. Muscle twitches are also known as myoclonic jerks. They are entirely involuntary and cannot be controlled or suppressed. [webmd.com]
A simple tic is purposeless, such as an eye blink, any other muscle twitch, a grunt, or a production of a noise. A complex tic consists of a muscle movement with a purpose, such as scratching, throwing, or chewing. [childbrain.com]
Face, Head & Neck
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Epistaxis
[…] breakdown, deformities of the fingers and thumbs, and paronychia Nail biting - Extremely short fingernails, paronychia, oral herpes, herpetic whitlow, damaged dentition, apical root resorption, fractures to the incisors, and gingivitis Nose picking - Epistaxis [emedicine.medscape.com]
Neurologic
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Radiculomyelopathy
Although the disability with Tourette's syndrome is often confined to social embarrassment, severe motor tics may lead to physical injury, including fractures, cervical radiculomyelopathy, joint dislocation, and falls. [web.archive.org]
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Recurrent Headache
headaches Breath-holding spells - Injury (from a fall), seizure Head banging - Callus formation, abrasions, contusions; skull fractures, eye injuries, and dental injuries are rare See Presentation for more detail. [emedicine.medscape.com]
Workup
See DDx and Workup for more detail. Management Childhood habits that do not interfere with everyday functioning often require no treatment. [emedicine.medscape.com]
[…] direct physiologic effects of a substance (eg, stimulants) or a general medical condition (eg, Huntington disease or postviral encephalitis) Criteria have never been met for Tourette’s disorder or persistent (chronic) motor or vocal tic disorder See Workup [emedicine.com]
Treatment
Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic [ncbi.nlm.nih.gov]
Prognosis
However, fully explanatory models are needed that would allow for more accurate prognosis and the development of targeted and efficacious treatments. [ncbi.nlm.nih.gov]
[…] value in prognosis. 4] Mild forms need not require treatment if they are socially functional. 15. [slideshare.net]
Prognosis Without treatment, it is expected that tics will have a waxing and waning course with exacerbations during stressful periods. [online.epocrates.com]
Shoulder shrugging Eye blinking Lip biting Facial grimacing Clearing of the throat Humming, sniffing, snorting, or squealing Child may report an uncomfortable feeling in his body before a tic occurs; this is called a “premonitory urge” Treatment and Prognosis [childmind.org]
Outlook (Prognosis) Simple childhood tics usually disappear over a period of months. Possible Complications There are usually no complications. A chronic motor tic disorder can develop. [health.ridgeviewmedical.org]
Etiology
Comorbidity data and family and linkage studies support the hypothesis that these phenotypes, in some cases, share a common etiology. [ncbi.nlm.nih.gov]
Epidemiology
As a result, after having examined the most relevant literature, authors sought to critically identify and discuss main epidemiologic, socio-demographic and clinical features characterising OCTD patients, along with other specific aspects including Health-Related [ncbi.nlm.nih.gov]
Robertson MM: The prevalence and epidemiology of Gilles de la Tourette syndrome. [f1000research.com]
Pathophysiology
These results are consistent with previous functional neuroimaging studies at rest that have widely involved the orbitofrontal cortex in the pathophysiology of the OCD. [ncbi.nlm.nih.gov]
The exact pathophysiological mechanisms are unknown, but the disorders are likely to be due to disturbances of the cortico-striatal-thalamo-circuitry. Comorbid conditions such as anxiety, obsessive-compulsive disorder, and ADHD are common. [bestpractice.bmj.com]
This review aims to guide clinicians in the recognition of the phenomenology, pathophysiology, and treatment of these disorders. [journals.lww.com]
Prevention
Such infections may be prevented by the prophylactic (preventative dose) administration of antibiotics, such as penicillin. [clinicaltrials.gov]
The guidelines also emphasize the importance of facilitating the dissemination of several behavioral treatment approaches, such as "Exposure Response Prevention", yet the most well documented being "Habit Reversal Training". [ncbi.nlm.nih.gov]
We provide short-term intensive treatment to target symptoms using Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) treatment strategies. [weillcornell.org]
Preventing tics is better than controlling them. Giving yourself free rein in terms of your actions, thoughts and emotions can reduce tension and hyperactivation, thereby preventing tics. [iusmm.ca]
Tics and Tourette’s Syndrome-oriented services at BCSC: Neuropsychological Assessment Comprehensive Behavioral Intervention for Tics (CBIT) Exposure and Response Prevention (ERP) [bostonchildstudycenter.com]