Showing papers on "Tourette syndrome published in 1977"
TL;DR: Patients and relatives with Tourette's syndrome, members of 21 selected families, participated in a 1-day clinic, and no evidence of abnormality was found in plasma dopamine beta hydroxylase, or norepinephrine levels.
Abstract: Eighty-one patients and relatives with Tourette's syndrome, members of 21 selected families, participated in a 1-day clinic. In 12 of the 13 Jewish families and six of the eight non-Jewish families, there were multiple members with motor and vocal tics by observation or history. Males predominated among those with persistent symptoms, but among those with spontaneous clearing, females predominated. Twelve propositi had troublesome sexual and aggressive impulses, differing only quantitatively from normal. No evidence of abnormality was found in plasma dopamine beta hydroxylase, or norepinephrine levels.
124 citations
TL;DR: A survey of patients with Tourette syndrome uncovered 32 who had been exposed to central nervous system stimulants, and 17 (53%) of these patients, symptoms were markedly accentuated by the drugs.
Abstract: A survey of patients with Tourette syndrome uncovered 32 who had been exposed to central nervous system stimulants. In 17 (53%) of these patients, symptoms were markedly accentuated by the drugs. Two patients whose Tourette syndrome developed suddenly when methylphenidate was administered are also reported.
100 citations
TL;DR: The adverse effects of methylphenidate and dextroamphetamine therapy on Tourette's syndrome supports the hypothesis that this condition results from a relative excess of CNS catecholaminergic activity.
Abstract: • Gilles de la Tourette's syndrome was independently ascertained in two male cousins once removed. Previous studies have shown familial clustering of individuals with tics, but no consistent pattern of inheritance of Tourette's syndrome has been apparent. The onset and later exacerbation of symptoms in our younger patient were associated with the administration of CNS stimulants given for excessive motor activity. The adverse effects of methylphenidate and dextroamphetamine therapy on Tourette's syndrome supports the hypothesis that this condition results from a relative excess of CNS catecholaminergic activity. Physicians prescribing these agents should inquire about the presence of tics in patients and their families.
59 citations
TL;DR: Many of the children have a history of encephalopathic events, "soft signs" on neurologic examination, and problems in school, and personal and social adjustmen are generally good, however.
Abstract: • I report the clinical details of Tourette syndrome in 15 children. The condition typically starts at age 6 years with eye-blinking, and the child soon develops other tics and abnormal vocalizations. Coprolalia and echolalia occur but are infrequent. The average delay in correct diagnosis in this series was four years. Treatment with haloperidol produces a good or excellent response in three quarters of the patients. Many of the children have a history of encephalopathic events, "soft signs" on neurologic examination, and problems in school. Personal and social adjustment are generally good, however. ( Am J Dis Child 131:531-534, 1977).
51 citations
TL;DR: This study highlights the need to understand more fully the role that language and social cues play in the development of Tourette's syndrome.
Abstract: Gilles de la Tourette syndrome is a neurologic disorder in which there are both motor and behavioral abnormalities, approximately 75 per cent of the patients are male and the onset of the disease i...
43 citations
TL;DR: Three young patients, two females and one male, presented the characteristic symptomatology of multiple tics, obsessive motor compulsions and coprolalia, which was accentuated when the patients tried to control it, especially in public.
Abstract: Three young patients, two females and one male, presented the characteristic symptomatology of multiple tics, obsessive motor compulsions and coprolalia. This symptomatology was accentuated when the patients tried to control it, especially in public. The patients had been treated with psychotherapy without benefit.
32 citations
23 citations
TL;DR: Three patients suffering from Gilles de la Tourette Syndrome were initially treated with haloperidol and have been followed for several months without recurrence of the original symptoms.
Abstract: Three patients suffering from Gilles de la Tourette Syndrome were initially treated with haloperidol. Depressive side effects and symptom breakthrough necessitated the search for another agent. The efficacy of lithium carbonate in treating stereotyped hyperkinetic behavior (such as is seen in Gilles de la Tourette syndrome) prompted the evaluation of lithium carbonate. An objective behavioral observation technique, clinical ratings and the patient's subjective reports were used to systematically record the response to treatment during the entire course of the study. Initially blood plasma Li+ levels in the 0.5 to 0.6 mEq/L range were obtained and these correlated with reduced frequency, as well as intensity, of involuntary motor acts (tics) and sounds. When the Li+ blood levels had stabilized at 0.8 to 0.9 mEq/L the major tics and involuntary sounds cleared dramatically. The patients experienced no side effects and have been followed for several months without recurrence of the original symptoms.
16 citations
TL;DR: Clinical data obtained in fifteen patients showed that chlorimipramine (CLI) a potent serotonergic blocking agent appears to have a good efficacy, with the advantage over haloperidol of having mild side effects.
Abstract: 1. 1. This investigation has yielded aggression and obsessive-compulsiveness as additional psychiatric symptoms to the neurological Gilles de la Tourette syndrome. 2. 2. Obsessive-compulsive relatives, as well as other Tourette family members seemed affected, suggesting a role of the genetic factors. 3. 3. Clinical data obtained in fifteen patients showed that chlorimipramine (CLI) a potent serotonergic blocking agent appears to have a good efficacy, with the advantage over haloperidol of having mild side effects. 4. 4. A serotonin disturbance as a causative factor was hypothesized.
16 citations
TL;DR: It is concluded that only the stimulants have a clearly established place, but that the less studied antidepressant and antipsychotic drugs almost certainly have a place too.
Abstract: The clinical use, methods of evaluation, safety and efficacy of psychotropic drugs in children are reviewed. It is concluded that only the stimulants have a clearly established place, but that the less studied antidepressant and antipsychotic drugs almost certainly have a place too. While the rather ill-defined hyperkinetic syndrome is the condition par excellence for drug therapy, other diagnostic entities, notably unsocialized, aggressive, and overanxious reactions, Gilles de la Tourette syndrome, school phobia, and the childhood psychoses appear to be drug responsive in some cases. Only an empirical trial of medication can answer the question of the role of pharmacotherapy in the management of the individual child. The substantial growth of pharmacotherapy in the last five years calls for a more medical and scientific approach to its use in children.
15 citations
TL;DR: Clinical observations suggest the hypothesis that patients who discontinue treatment with haloperidol for at least three weeks, and side effects from the medicine persisted for three months, suggest that Gilles de la Tourette syndrome can be successfully treated only if the dosage of haloperidine is titrated very slowly.
Abstract: To the Editor.— Based on study of and experience with more than 450 patients and treatment of more than 250 patients with Gilles de la Tourette syndrome, 1 we have identified a group of patients who can be successfully treated only if the dosage of haloperidol is titrated very slowly, perhaps in increments of 0.25 mg/day every three weeks. This slow treatment method grew out of several observations during our treatment of patients. Some patients elected to or found it necessary to discontinue administration of the medicine because of side effects. Tic symptoms usually return and side effects usually disappear four days after stopping administration of the medicine. In some patients the tic symptoms did not fully reappear after discontinuing treatment with haloperidol for at least three weeks, and side effects from the medicine persisted for three weeks. These clinical observations suggest the hypothesis that patients who discontinue treatment with
TL;DR: The fever settled spontaneously next day but the tachycardia persisted, slowing to 100/min over the five days' stay, and with resolution of the fever a pleomorphic erythematous rash developed on the trunk and lasted less than 24 hours.
Abstract: particularly around the terminal phalanges. Auscultation of the heart showed no abnormality. Erythrocyte sedimentation rate was 45 mm in the first hour; urine contained 1 g protein/l, three red cells and five leucocytes per high-power field, and some cellular casts; and mouth culture yielded a small growth of Candida, and facial swabs a mixed growth of organisms. The table lists the serological titres. An electrocardiogram showed sinus tachycardia and a prolonged corrected Q-T interval of 0 4 s but was normal three weeks later. Full blood count, plasma urea and electrolytes, serum alanine and aspartate transaminases, plasma proteins, and a chest radiograph were all normal. The fever settled spontaneously next day but the tachycardia persisted, slowing to 100/min over the five days' stay. With resolution of the fever a pleomorphic erythematous rash developed on the trunk and lasted less than 24 hours. The facial rash became more impetiginous, and she was discharged taking flucloxacillin, Two weeks later the facial rash had healed and minimal palmar desquamation was present.
Journal Article•
TL;DR: Deanol (dimethyl aminoethanol) is a putative cholinergic agonist and has reported effectiveness in conditions where there is a predominance of dopaminergic versus Cholinergic activity, e.g. levodopa-induced dyskinesias, neuroleptic induced tardive dyskinisia, and Huntington's chorea.
Abstract: On the basis of its pharmacologic action Deanol (dimethyl aminoethanol) was hypothesized to be of benefit in the Gilles de la Tourette Syndrome. In one case report the addition of Deanol to perphenazine did not result in an improvement of uncontrollable movements or involuntary speech utterances. Gilles de la Tourette Syndrome is a condition combining organic and psychogenic features existing in the interface between two etiologies. Classically the disease begins in childhood and is characterized by the appearance of sudden involuntary movements, involuntary speech utterances frequently consisting of curse words (coprolalia), and imitative phenomena such as echolalia and echopraxia. Neurotic symptomatology such as anxiety and obsessive thinking have also been reported. This condition is regarded neuropharmacologically as a dopaminergic state that responds to drugs with antidopaminergic activity e.g. the phenothiazines and butyrophenones. Deanol (dimethyl aminoethanol) is a putative cholinergic agonist and has reported effectiveness in conditions where there is a predominance of dopaminergic versus cholinergic activity, e.g. levodopa-induced dyskinesias, neuroleptic induced tardive dyskinesia, and Huntington's chorea. Because of its effectiveness in dopaminergic states it was hypothesized that Deanol could also be of benefit in the Gilles de la Tourette Syndrome.
Book•
01 Jan 1977
TL;DR: The on-Off Effect in Parkinson's Disease Treated with Levodopa with Remarks Concerning the Effects of Sleep is discussed.
Abstract: Invited Speakers.- Historical Aspects and Frontiers of Parkinson's Disease Research.- Discussion Flemenbaum, Frigyesi, delaTorre, Fahn, Flores Volkman, Mars, Klawans, Duvoisin, Calne.- Recent Advances in the Biochemical Pharmacology of Extrapyramidal Movement Disorders.- Discussion Frigyesi, Klawans, Flemenbaum, Duvoisin, FahnMars, Calne, Pirch, Volkman, Flores, Hornykiewicz.- Treatment of Parkinsonism.- Discussion Frigyesi, delaTorre, Fahn, Duvoisin, Mars Hunt, Volkman, Potter, Franz.- Parkinsonism and Epilepsy.- Discussion Barnes, Messiha, Pirch, Lake, Duvoisin, Fahn.- Neurophysiology of Movement Disorders.- Problems in the Treatment of Parkinsonism.- Discussion Fahn, Mars, Calne, Messiha, Pirch, Clark.- New Approaches in the Management of Hyperkinetic Movement Disorders.- Discussion de la Torre, Mars, Duvoisin, Calne, Potter, Messiha.- Submitted Short Communications.- The On-Off Effect in Parkinson's Disease Treated with Levodopa with Remarks Concerning the Effects of Sleep.- Adenylate Cyclase from Various Dopaminergic Areas of the Brain and the Action of Loxapine.- Pharmacopsychiatry and Iatrogenic Parkinsonism.- Comparison of Lithium and Haloperidol Therapy in Gilles de la Tourette Syndrome.- Dopamine Receptors Hypersensitivity: Further Confirmation Following Drug Abuse Model.- L-Dopa-Induced Hypotension: Depression of Spinal Sympathetic Neurons by Release of 5-Hydroxytryptamine.- Antinociciptive effect of Dopaminergic Neurotransmission Evoked by Mesencephalic Stimulation on Spinal Interneuronal Activity in Cats.- The Parkinsonian Syndrome and its Dopamine Correlates.- CNS Compensation to Dopamine Neuron Loss in Parkinson's Disease.- Brain Dopamine Turnover and theRelief of Parkinsonism.- Evaluation of Experimental Anticholinergic Drug, Elantrine, in Treating the Tremor of Parkinsonism.- Maternally Determined Susceptibility to D-Amphetamine-Induced Stereotypyin Rats.- Postmenopausal Parkinsonism: BrainIron Overload?.- Failure of L-Dopato Relieve Activated Rigidity in Parkinson's Disease.- SubjectInde.