Showing papers on "Tourette syndrome published in 1989"
TL;DR: Data from 105 subjects support the construct, convergent, and discriminant validity of the instrument, and indicate that the YGTSS is a promising instrument for the assessment of tic severity in children, adolescents and adults.
Abstract: Despite the overt nature of most motor and phonic tic phenomena, the development of valid and reliable scales to rate tic severity has been an elusive goal. The Yale Global Tic Severity Scale (YGTSS) is a new clinical rating instrument that was designed for use in studies of Tourette's syndrome and other tic disorders. The YGTSS provides an evaluation of the number, frequency, intensity, complexity, and interference of motor and phonic symptoms. Data from 105 subjects, aged 5 to 51 years, support the construct, convergent, and discriminant validity of the instrument. These results indicate that the YGTSS is a promising instrument for the assessment of tic severity in children, adolescents and adults.
1,850 citations
TL;DR: A review briefly considers early descriptions of GTS as well as current research, highlighting the areas of agreement and controversy.
Abstract: The Gilles de la Tourette Syndrome is a movement disorder characterised by both motor and vocal (phonic) tics. It was once thought to be rare, and the literature until the 1970s consisted predominantly of case reports, both highlighting the fascinating clinical manifestations and speculating as to their aetiology. Many areas of GTS are under investigation, including the neurology, psychopathology, neurophysiology, biochemistry, and genetics. This review briefly considers early descriptions of GTS as well as current research, highlighting the areas of agreement and controversy.
330 citations
TL;DR: Clinical correlates of self-injury were the severity of Gilles de la Tourette syndrome symptoms and psychopathology, with special reference to obsessionality and hostility.
Abstract: Thirty (33%) of 90 patients with the Gilles de la Tourette syndrome exhibited self-injurious behaviour. Fourteen were head bangers, of whom two had cavum septum pellucidum. Clinical correlates of self-injury were the severity of Gilles de la Tourette syndrome symptoms and psychopathology, with special reference to obsessionality and hostility. We discuss an additional patient who died from a subdural haematoma as a result of head banging, and three who had permanent vision impairment from self inflicted eye injuries.
164 citations
TL;DR: A survey of 34 randomly selected TS patients indicates that sensory tics are common and should be considered part of a clinical spectrum of tics and associated sensory phenomena.
Abstract: Sensory tics are localized uncomfortable sensations for which patients attempt to obtain relief by producing movements or vocalizations. We report 3 patients with Tourette's syndrome (TS) and sensory tics to illustrate this poorly recognized symptom. A survey of 34 randomly selected TS patients indicates that sensory tics are common and should be considered part of a clinical spectrum of tics and associated sensory phenomena.
133 citations
113 citations
TL;DR: Evidence supports that long-term treatment with neuroleptics does not cause tardive dyskinesia, and their fundamental action may be to interact with a neurological process that is an intrinsic neurodevelopmental or atrophic component of the disorder for which that treatment is prescribed.
Abstract: Publisher Summary The tardive dyskinesia refers to a syndrome of abnormal, involuntary, choreoathetoid movements that emerges as a late-onset, adverse effect of long-term treatment with neuroleptic drugs. This syndrome is seen only in a proportion of patients so treated, and when present can affect the orofacial, limb, and trunk regions of the body and the respiratory musculature; classical buccal-lingualmasticatory dyskinesia is perhaps the most widely considered manifestation. Concept of tardive dyskinesia including phenomena such as tardive dystonia, tardive Tourette syndrome, and tardive akdthisia. Clearly, to investigate the syndrome of tardive dyskinesia, one must exclude patients with extrapyramidal disorders, such as Huntington's disease, which are known to involve involuntary, choreoathetoid movements as an inherent feature of the illness independent of any possible exposure to neuroleptics. Evidence supports that long-term treatment with neuroleptics does not cause tardive dyskinesia. Rather, their fundamental action in this regard may be (1) to interact with a neurological process that is (usually) an intrinsic neurodevelopmental or atrophic component of the disorder for which that treatment is prescribed, and (2) to hasten the emergence of an inappropriate and overelaborated form of an innate buccal-lingual-masticatory motor pattern that has an unappreciatedly high likelihood of ultimately occurring spontaneously with increasing cerebral dysfunction.
96 citations
TL;DR: The results illustrate the relative frequency of psychopathology in Tourette syndrome and emphasize the need for a comprehensive approach to this syndrome.
86 citations
TL;DR: The blink reflex and it's recovery cycle were studied in patients with Gilles de la Tourette syndrome and controls and there was a significant increase in the mean duration of the R2 response and the amplitude of R2 following paired shocks.
Abstract: The blink reflex and it's recovery cycle were studied in 26 patients with Gilles de la Tourette syndrome and 10 controls. There was a significant increase in the mean duration of the R2 response. The amplitude of the R2 response following paired shocks (mean R2[T]/R2[C]%) was 11%, 40% and 52% of the conditioning stimulus with intervals of 200 ms, 500 ms and 1 second in the patients, compared with 10%, 17% and 32% respectively in the controls. Half the patients, however, had normal recovery cycles and voluntary suppression of tics and blinks reduced the amplitude of R2 in all patients. These results suggest increased excitability of brainstem interneurons in Gilles de la Tourette syndrome.
86 citations
TL;DR: Nicotine was found to markedly potentiate haloperidol-induced hypokinesia in rats and may prove useful for treating other neuroleptic responsive disorders, such as schizophrenia and Huntington's disease.
86 citations
TL;DR: It appears that the use of nicotine or cannabinoids may greatly improve the clinical response to neuroleptics in motor disorders.
50 citations
TL;DR: Evidence suggesting many individuals with Tourette syndrome may be homozygous for a "Tourette syndrome" gene is reviewed, and observations suggest the inheritance in TS may be best described as semi-dominant, semi-recessive.
Abstract: We review evidence suggesting that many individuals with Tourette syndrome (TS) may be homozygous for a "Tourette syndrome" gene. This is based on experience with pedigrees on 1,200 TS families, comparison of the occurrence of tics or associated behaviors such as obsessive-compulsive behavior, panic attacks, attention deficit hyperactivity disorder, and/or severe alcohol or drug abuse, on both the maternal and paternal side in 170 TS families compared to control families, biochemical studies of blood serotonin and tryptophan levels, and other evidence. These observations suggest the inheritance in TS may be best described as semi-dominant, semi-recessive. Some of the implications of this proposal are discussed.
TL;DR: The case of a 27‐year‐old man who developed multiple motor tics following closed head trauma with loss of consciousness is presented, and it is unlikely that the patient had Gilles de la Tourette syndrome.
Abstract: We present the case of a 27-year-old man who developed multiple motor tics following closed head trauma with loss of consciousness. Age of onset, lack of family history of tics, and atypical progression of tic severity and location make it unlikely that the patient had Gilles de la Tourette syndrome. Previous reports of post-traumatic tic syndrome are discussed.
TL;DR: It is felt that pain should be recognized as a common complaint, and occasionally a source of significant disability, in patients with tics, and by patients who obtain relief from tics while experiencing pain.
Abstract: Although pain is not generally recognized as a symptom of tic disorders, we have seen a number of patients in whom this was a prominent feature, at times even the symptom of greatest concern. The commonest pain complaints are those arising from the actual performance of a tic. Most often this follows directly from the discomfort produced by sudden or repeated extreme exertion. Here the origin of the pain is usually musculoskeletal, though rare examples of neuropathic pain may occur. Pain also may arise from striking or being struck by a moving body part involved in large amplitude tics. Other related painful acts include deliberate self-injury and pain inflicted upon others. A second major category is represented by a smaller number of patients who complain of pain during voluntary efforts to suppress their tics. Finally, there are patients who obtain relief from tics while experiencing pain, to such an extent that they will deliberately provoke pain to obtain its benefit. We feel that pain should be recognized as a common complaint, and occasionally a source of significant disability, in patients with tics.
TL;DR: It is concluded that the Gilles de la Tourette syndrome should not be viewed as a tic disorder, but a far more complex condition in which the tics form but one aspect.
Abstract: Attention is drawn to associations between movement disorders and psychopathology. The historical background of this is briefly reviewed, and then some recent research findings with regards to the Gilles de la Tourette syndrome are presented. In particular, associations between aggressive and obsessive compulsive disorder and Gilles de la Tourette movements are reported. Further there are associations between a family history of tics and obsessive compulsive disorder in the subsequent generation. It is concluded that the Gilles de la Tourette syndrome should not be viewed as a tic disorder, but a far more complex condition in which the tics form but one aspect.
TL;DR: The motor and cognitive effects of a selective D-1 dopamine receptor agonist, SKF 39393, were assessed in patients with Huntington's disease, Gilles de la Tourette's syndrome, tardive dyskinesia, and torsion dystonia, using a double-blind placebo-controlled design.
Abstract: The motor and cognitive effects of a selective D-1 dopamine receptor agonist, SKF 39393, were assessed in patients with Huntington's disease, Gilles de la Tourette's syndrome, tardive dyskinesia, and torsion dystonia, using a double-blind placebo-controlled design. Over daily doses ranging from 3.2 to 32 mg/kg and treatment intervals extending from one to seven weeks, no consistent changes could be discerned. The contribution of D-1 receptor mediated mechanisms to the pathophysiology of hyperkinetic extrapyramidal disorders remains uncertain.
TL;DR: The results indicated that the children's perceptions of their parents' behavior explained the most variance in children's self-concepts and anxiety for both groups, highlighting the importance of the parent-child interaction in predicting the child's emotional adjustment to Tourette's syndrome.
Abstract: We investigated the predictive value of family reaction and illness severity with respect to the emotional adjustment of Tourette's syndrome patients. The subjects included 30 children with Tourette's syndrome and 30 control subjects matched on age, sex, race, and socioeconomic status. The predictor variables included the child's perception of parental behavior, family adaptability as perceived by the mother, mother's self-concept, and illness severity. The results indicated that the children's perceptions of their parents' behavior explained the most variance in children's self-concepts and anxiety for both groups. These findings highlight the importance of the parent-child interaction in predicting the child's emotional adjustment to Tourette's syndrome.
TL;DR: The presence of visual field anomalies was measured using Goldmann kinetic perimetry in twelve patients, age 7 to 39 with Gilles de la Tourette syndrome, and represents clear evidence of additional physical components in this condition.
Abstract: The presence of visual field anomalies was measured using Goldmann kinetic perimetry in twelve patients, age 7 to 39 with Gilles de la Tourette syndrome. Refraction to the cupola was carefully controlled.
01 Dec 1989
TL;DR: The histories of the patients and their families provide clinical support for the hypothesis of a significant relationship between TS and psychiatric disorders and suggests that clinicians should be alert to the presence of an underlying TS diathesis in their patients.
Abstract: Psychiatric disturbances are frequent in Tourette syndrome (TS) patients but their relationship to the tic disorder is controversial. The report of a high prevalence of psychiatric disorders in TS relatives with or without tics compared with controls supports the hypothesis that neuropsychiatric disturbances are variant expressions of the TS gene. This combined with the report of a high prevalence of the tic disorder suggests that TS may contribute significantly to the etiological heterogeneity of a wide array of psychiatric disorders. The following is a report of patients who sought treatment because of disabling psychiatric symptoms and in whom the diagnosis of a TS diathesis was made for the first time as an incidental observation during the evaluation. The histories of the patients and their families provide clinical support for the hypothesis of a significant relationship between TS and psychiatric disorders and suggests that clinicians should be alert to the presence of an underlying TS diathesis in their patients.
Journal Article•
TL;DR: Tourette Syndrome is a neurological disorder of unknown origin that encounters tics and often additional behaviors such as speech, sleep, and learning difficulties, as well as social isolation.
Abstract: Tourette Syndrome is a neurological disorder of unknown origin. The individual suffering from Tourette Syndrome encounters tics and often additional behaviors such as speech, sleep, and learning difficulties, as well as social isolation.
Journal Article•
TL;DR: Surprisingly, it was found that patient gender rather than family history was more likely to predict a successful treatment outcome with haloperidol, suggesting a complex, multifactorial pathology for Tourette syndrome that extends beyond a simple dopamine receptor dysfunction.
Abstract: The relationship between a medication course with haloperidol (Haldol) and family history for any type of tics was examined in a survey of 196 Tourette syndrome patients. Those with no family history of tics had a high probability of success with haloperidol therapy only. A positive family history increased the likelihood of medication changes after an initial trial of the drug. Surprisingly, we found that patient gender rather than family history was more likely to predict a successful treatment outcome with haloperidol. The data suggest a complex, multifactorial pathology for Tourette syndrome that extends beyond a simple dopamine receptor dysfunction and points to the influence of patient gender on treatment outcome.
Journal Article•
TL;DR: It was observed that haloperidol was effective to this syndrome with or without epileptiform discharge, and antiepileptic agents, which might alter the metabolism of dopamine, was not recommended for treating GTS patients.
Abstract: This report presents the clinical observation of 3 cases of Gilles de la Tourette Syndrome (GTS) with epileptiform discharge of electroencephalogram (EEG). During the past 2 years (1986-1987), 8 cases of GTS were diagnosed in the pediatric department of National Taiwan University Hospital. Three of them persented epileptiform discharges. Diffuse bilateral parieto-occipital spikes in waking and light sleep periods were noted in case 1, who was a 10-year-old girl. Case 2 was a 9-year-old boy, his EEG showed sporadic spikes over right fronto-central area during light sleep. In case 3, a 6-year-old boy, frequent sharps and spikes appeared in left centro-temporal area in waking and sleep EEG. Case 3 had received antiepileptic therapy. The REG recovered to normal, the symptoms of the involuntary movement became more prominent. All of the 3 cases improved significantly after haloperidol monotherapy. Based on the clinical observations and literature review, we noted that the incidence of epileptiform discharge in GTS was higher than that in nonepileptic normal population. Although some authors suggested that a seizure state possibly play a subtle role in the genesis of Tourette’s symptoms, this inference was not supported by our experience. We observed that haloperidol was effective to this syndrome with or without epileptiform discharge. Therefore, antiepileptic agents, which might alter the metabolism of dopamine, was not recommended for treating GTS patients.
Journal Article•
TL;DR: Cerucal proved effective in patients with psycho-asthenic+ traits in children with Tourette syndrome, and Personality types were described which presented a continuum between asthenic and psycho-astshenic poles.
Abstract: The action of cerucal was investigated in 22 children with Tourette syndrome. Positive effect was obtained in 59.1% of the cases. Personality types were described which presented a continuum between asthenic and psycho-asthenic+ poles. Cerucal proved effective in patients with psycho-asthenic+ traits.
01 Jan 1989
Journal Article•
TL;DR: A retrospective chart review and follow-up questionnaire related to the otolaryngologic aspects of Tourette syndrome were undertaken.
Abstract: The otolaryngologist may be consulted to see such a patient because of head neck or facial tics or more often because of phonic or vocal tics such as throat-clearing, sniffing, coughing or abnormal noises. As this disorder has not appeared in the otolaryngologic literature we undertook a retrospective chart review (N=72) and follow-up questionnaire related to the otolaryngologic aspects of this disorder
Journal Article•
TL;DR: Results showed that L-SPD is a new type of anti-dyskinesia agent deserving further pharmacological investigation.
Abstract: 134 cases of dyskinesia caused by various CNS diseases were treated with a new type of DA blocker L-Stepholidine (1-SPD). Good response was obtained in 72% (29/40) of L-dopa induced abnormal involuntary movements in Parkinson disease, 79% (34/43) of Tourette syndrome, and 65% (15/23) of tardive dyskinesia through a short-term follow-up. No serious side effects were found within the therapeutic dosage of 50-225mg/day The results showed that L-SPD is a new type of anti-dyskinesia agent deserving further pharmacological investigation.
Journal Article•
TL;DR: This paper is to provide physicians with guidelines for the pharmacological treatment of Tourette syndrome, based on the present available literature.
Abstract: Tourette syndrome is now widely accepted as a neurological disorder characterized by chronic multiple tics and uncontrollable sounds The exact etiology of Tourette syndrome is still unknown, although an organic etiology is suspected Hypotheses of the pathophysiologic mechanism of Tourette syndrome have generally included a component of neurotransmitter system "imbalance" Dopaminergic, cholinergic, serotoninergic, noradrenergic and peptidergic neurotransmitters have all been proposed as components of this "imbalance" The two most utilized agents, haloperidol and pimozide, decrease central dopaminergic activity by blocking dopamine receptors and have been shown to improve the symptomatology of Tourette syndrome However, adverse effects limit their usefulness and new drugs that have fewer adverse effects and greater efficacy are needed Some of the new therapeutic agents evaluated in Tourette syndrome are mentioned The purpose of this paper is to provide physicians with guidelines for the pharmacological treatment of Tourette syndrome, based on the present available literature
TL;DR: Routine EEG findings and computed EEG topography in otherwise neurologically intact unmedicated patients with GdIT are described.
Abstract: Gilles de la Tourette syndrome (GdIT) is a neuropsychiatric disorder characterized by the onset in childhood or adolescence of motor tics and vocalizations. Recent studies support an organic basis. This report describes routine EEG findings and computed EEG topography in otherwise neurologically intact unmedicated patients with GdIT
TL;DR: A case of Gilles de la Tourette's syndrome is described, in which a state of akinesia developed during an attempt to withdraw lorazepam by diazepam substitution, followed by sustained amelioration of the TS symptoms.
Abstract: A case of Gilles de la Tourette's syndrome (TS) is described, in which a state of akinesia developed during an attempt to withdraw lorazepam by diazepam substitution. This was followed by sustained amelioration of the TS symptoms.
11 Jun 1989
01 Jan 1989
TL;DR: This chapter focuses on three forms of childhood psychopathology: transient tic Disorder, chronic tic disorder, and Tourette’s disorder.
Abstract: This chapter focuses on three forms of childhood psychopathology: transient tic disorder, chronic tic disorder, and Tourette’s disorder Separately, these disorders occur in children relatively infrequently, but all are particularly troublesome to the children who evince them Tic behaviors usually develop during middle childhood, and nearly always before adulthood Within the realm of specific behavioral disorders, tic disorders represent the more general category of childhood habit disorders