Showing papers on "Tourette syndrome published in 1984"

Tourette's Syndrome and Attention Deficit Disorder with Hyper activity: Are They Genetically Related?

Abstract: Based on a series of 250 consecutive, unselected patients with Tourette's syndrome (TS), all examined in a prospective manner, we address the relationship between TS and attention deficit disorder (ADD) with hyperactivity. ADD with hyperactivity was present in 62% of TS male patients under 21 years of age. Examination of family pedigrees suggested that the TS gene could be expressed as ADD with hyperactivity but without tics. In 91 patients with hyperactivity sufficient information was available to determine the duration from onset of hyperactivity to onset of TS symptoms. The mean was 3.0 years. For 18 patients treated with stimulants before the onset of tics (Group IIA: hyperactivity stimulant medication tics) this duration was 5.3 years. For 35 patients treated with stimulants after the onset of tics (Group IIB: hyperactivity tics stimulant medication) this duration was 1.6 years. The presence of a positive family history for TS was not significantly different in these two groups—72.2% vs. 78.8%. When all patients with a simultaneous onset of hyperactivity and tics were removed from Group IIB, the duration from onset of hyperactivity to tics was 4.0 years, still less than in Group IIA. The combined data suggest that patients with hyperactivity who develop tics after treatment with stimulants had ADD due to a TS gene and probably would have developed tics without stimulant treatment.

A clinical study of Gilles de la Tourette syndrome in the United Kingdom.

Abstract: The clinical features of 53 British-born patients with Gilles de la Tourette syndrome are described. The mean age at onset of body tics was seven years and for vocalisations 11 years. Coprolalia was present in 39%, copropraxia in 21%, echolalia in 46% and echopraxia in 21%. Complicated antics and mannerisms were also common, often involving the compulsive touching of objects or self-injurious behaviour. Forty-six per cent of cases had a family history of tics in a single close relative and in two individuals a further member of the family had Gilles de la Tourette syndrome. Focal dystonia was present in four patients who had never received neuroleptics drugs and chorea was seen in two other untreated patients. In three patients acoustic startle consistently induced brief eye blink followed by a whole body jerk or jump. Rapid repetitive movements of the hands increased the frequency and severity of tics in 13 patients, but the performance of mental arithmetic under time pressure had a much more unpredictable effect. Electroencephalographic abnormalities occurred in eight (13%) but no definite CT brain scan abnormalities were detected. The incidence of left handedness did not differ from that in the general population and no evidence to suggest organic impairment was found on neuropsychological testing. This study provides no support for the notion that Gilles de la Tourette syndrome is a degenerative disorder of the central nervous system but provides some evidence for heterogeneity.

An Overview of Clinical Experience

Abstract: Twelve years of experience with more than 300 patients with Gilles de la Tourette's syndrome are reviewed. During this period the concept of the syndrome has changed to now include much milder cases. The main chemical treatment is haloperidol and clonidine, but emphasis is also placed on psychotherapy and supportive measures by auxiliary parapsychological services.

Complex segregation analysis of Gilles de la Tourette syndrome: further evidence for a major locus mode of transmission.

Abstract: A sample of 35 published pedigrees of Gilles de la Tourette syndrome is studied using complex segregation analysis with pointers. Results indicate the presence of a rare, semidominant, incompletely penetrant allele leading to affection. This result is consistent with that previously reported by Comings et al. on a larger, independent sample.

Mental health needs associated with Tourette syndrome.

Abstract: Tourette Syndrome (TS) is an uncommon developmental disability characterized by repetitive and involuntary verbal and motor tics. A survey of all known affiliates of the Tourette Syndrome Association of Ohio was conducted. A total of 431 questionnaires was returned, and behavioral problems were found to be pervasive in Tourette people. Some 53.1 per cent of the sample had sought some form of counseling for these problems, but this counseling was generally not perceived as being very helpful. Medication was not reported to ameliorate behavioral problems. When compared to a normal population sample, self-ratings of mental health status were low among Tourette persons. Problems experienced by TS persons were aggregated into a Behavioral Problem Scale, which successfully discriminated between levels of need in TS persons.

Disorders of arousal in Gilles de la Tourette's syndrome.

Abstract: Disorders of arousal (somnambulism and night terrors) were significantly more common among children with Gilles de la Tourette's syndrome (n = 57) than among children with seizure disorders (n = 58) or learning disabilities (n = 53). Neurohumoral disturbances may account for the differences.

Children with Tourette syndrome: results of psychological tests given prior to drug treatment.

Abstract: There have been several recent reports on the neuropsychological integrity of children and adults with Tourette syndrome (TS). However, the possible effects of tic-controlling medications on the test performance of subjects have not been thoroughly investigated, although drugs commonly used in the treatment of TS, such as haloperidol, have been shown to affect learning and behavior. In this study, 10 children diagnosed as having Gilles de la Tourette syndrome were individually administered a battery of psychological tests prior to starting drug treatment. Since a wide range of deficits and processing inefficiencies has been reported in association with the psychological functioning of children with Tourette's disorder, the test battery used was designed to include both measures of contemporary global functioning and measures designed to focus upon particular functional areas. Data analyses revealed a number of specific impairments in TS children relative to age-appropriate levels and levels of global functioning (i.e., IQ scores). The study revealed a number of graphomotor, nonmotor visual-perceptual, and receptive verbal deficits. In addition, a high frequency (50%) of the sample manifested significant Verbal-Performance IQ discrepancies. Results of this study, on a population of nonmedicated TS children, substantiated and extended findings of several previous reports which identified a number of circumscribed weaknesses in the functioning of children with Tourette's disorder.

Tourette syndrome, atypical pervasive developmental disorder and Ganser syndrome in a 15-year-old, visually impaired, mentally retarded boy.

Abstract: This is a case report of a 15-year-old visually impaired, mentally retarded male who presents with symptoms consistent with Tourette Syndrome, a Syndrome of approximate answers (Ganser's Syndrome) and Atypical Pervasive Developmental Disorder. The authors feel that this follow-up on the case presented earlier by Parraga and Butterfield raises the possibility of a link between a number of the symptoms of adult schizophrenia, appearing in attenuated form in these two cases, and Tourette Syndrome.

Provocative drug testing in Tourette's syndrome: d- and l-amphetamine and haloperidol.

Abstract: Tourette's syndrome (TS) has become the focus of more intensive investigation in recent years as a model neuropsychiatric disorder with precisely defined clinical diagnostic criteria and symptoms which are often responsive to pharmacotherapeutic intervention. In this provocative study, six TS patients were given doses of d-amphetamine, l-amphetamine, and haloperidol, in order to evaluate whether acute drug administration might provide a means of further clarifying the neurochemical pathophysiology of TS. Our patients experienced a heterogeneous array of responses, which precluded inferences regarding the neurochemistry of TS. Our results, however, illuminated many of the difficulties which confront investigators wishing to do behavioral pharmacologic research with TS patients, and provided insight into the complex nature of this neurobehavioral disorder.

EEG abnormalities in Tourette's syndrome.

Abstract: Electroencephalographic (EEG) abnormalities in a series of 45 patients with Tourette's syndrome were related to clinical and historical factors in this study. Twenty-one of the 45 tracings (47%) exhibited abnormalities; the most common abnormalities noted included sharp waves and slowing. A posterior focus of abnormal activity was noted in 16 cases. Subjects with an earlier age of onset were significantly more likely to have abnormal EEGs.

Tourette syndrome: A review and educational implications

Abstract: Tourette syndrome has recently been brought to public attention through popular media. This review of the literature is an effort to communicate to special educators and allied professionals in nonmedical terms the present state of the art with regard to the definition, symptoms, etiology, treatment, and educational implications of Tourette. The review is concluded with suggestions for the education of Tourette students.

Gilles de la Tourette disorder: A review

Abstract: Gilles de la Tourette disorder, a relatively rare disorder characterized by multiple motor and vocal tics, is reviewed. Issues associated with its incidence, etiology, assessment, and treatment are examined. Special attention is focused upon its diagnosis since Tourette is often times misdiagnosed and confused with disorders of psychogenic origin. Suggestions for future research include the use of more sophisticated assessment strategies and the development of integrated treatment packages. In addition, continued investigation of issues surrounding its etiology, particularly on a neurophysiological level, is needed.

Tourette's syndrome: update

Abstract: Tourette's syndrome is a widely misunderstood chronic disorder that develops in childhood and is usually lifelong. It is characterized by waxing and waning of involuntary motor and phonic tics. The features and differential diagnosis are discussed in this paper. The estimated prevalence rate of Tourette's syndrome, 0.05%, implies that this disorder is not rare. The reasons for diagnostic confusion are outlined, and the genetic and neurotransmitter features discussed. The management of Tourette's syndrome has become more effective with the availability of at least two psychoactive drugs, haloperidol and pimozide. Although the cause of this syndrome is thought to be organic, these drugs and their adverse effects are best known to psychiatrists. Psychiatric and multidisciplinary intervention is often necessary because of the frequent association of psychosocial problems, cognitive and learning difficulties, and aggravation of the symptoms by stress. The understanding of Tourette's syndrome will probably increase significantly with the advent of the newer imaging techniques and the rapid progress of research in the neurosciences.

Pathogenesis of hyperkinesias in children.

Abstract: Hyperkinesias are oneof the most widespread symptoms of nervous-system lesion in children. They are subdivided by purely external manifestations into choreic, athetosic, tic, myoclonic, and torsional. The pathogenetic mechanisms underlying hyperkinesias are far from being completely elucidated. From a pathophysiological point of view, hyperkinesias are usefully subdivided into two groups -rapid, or phasic, and slow, or tonic.