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1、TouretteSyndromeChildPsychopathologyFall2005SusanBongiolatti,M.S.TouretteSyndrome:IntroductionNeurologicaldisordercharacterizedbyrepetitive,involuntarymovementsandvocalizationscalledticsTypicalonsetinearlychildhoodoradolescencebetweentheagesof2and15TouretteSyn
2、drome:HistoryIn1825,ItarddescribedthecaseoftheMarquisedeDampierre,aFrenchnoblewomanBeginningatage7,shereportedly“tickedandblasphemed”Persisteduntilherdeathatage86History:GeorgesGillesdelaTouretteGeorgesGillesdelaTouretteFrenchneurologist,studentofCharcotIntere
3、stinhysteria,hypnotismIn1885,publishedpaperdescribingmalidiedesticsStudyof9patients,includingMarquisedeDampierrePatientscharacterizedbyconvulsivetics,obsceneutterances,repetitionofothers’wordsCharcotrenamedit“GillesdelaTouretteSyndrome”Whataretics?Repetitive,s
4、udden,involuntaryorsemivoluntarymovementsorsoundsNon-rhythmicMayappearasexaggeratedfragmentsofordinarymotororphonicbehaviorsthatoccuroutofcontextClassificationMotororPhonic(vocal)SimpleorcomplexMotorTicsSimplemotorticsInvolvesinglemuscleorfunctionallyrelatedgr
5、oupofmusclesFastandbrief,lasting<1secMayoccurinboutsofrapidsuccessionComplexmotorticsInvolvemoremusclegroupsSequentiallyand/orsimultaneouslyproducedmovementsMayappearpurposefulPhonicTics“Phonic”vs.“Vocal”SimplephonicticsSingle,meaninglesssoundornoiseComplexpho
6、nicticsLinguisticallymeaningfulutterancesandverbalizationsSimpleComplexMotorticsEyeblinkingNosewrinklingJawthrustingShouldershruggingWristsnappingNeckjerkingLimbjerkingAbdominaltensingHandgesturesFacialcontortionsJumpingTouchingRepeatedlysmellingobjectSquattin
7、gCopropraxiaEchopraxiaPhonicticsSniffingBarkingGruntingThroatclearingCoughingChirpingScreamingSinglewordsorphrasesPartialwordsorsyllablesRepeateduseofwordorwordsoutofcontextPalilaliaEcholaliaCoprolaliaTics:OthercharacteristicsPremonitoryfeelingsorsensationsMay
8、betemporarilysuppressedSuggestibilityinsomeindividualsMayincreasewithheightenedemotion(e.g.,anger,excitement)Oftenoccurwhilerelaxing,andmayincreaseduringrelaxationafterstressMaydim