Tourette syndrome - Wikipedia
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An example of this is when diagnostic confusion between tics and seizure activity exists, which would call for an EEGor if there are symptoms that indicate an MRI to rule out brain abnormalities. Brain imaging studies are not usually warranted. If a family history of liver disease is present, serum copper and ceruloplasmin levels can rule out Wilson's disease.
Other possibilities include chromosomal disorders such as Down syndromeKlinefelter syndromeXYY syndrome and fragile X syndrome. Acquired causes of tics include drug-induced tics, head trauma, encephalitisstrokeand carbon monoxide poisoning.
Children and adolescents with TS who have learning difficulties are candidates for psychoeducational testing, particularly if the child also has ADHD. Complications may include depressionsleep problemssocial discomfort, self-injury anxietypersonality disordersoppositional defiant disorderand conduct disorders. Treatment of Tourette syndrome The treatment of Tourette's focuses on identifying and helping the individual manage the most troubling or impairing symptoms.
There is no cure for Tourette's and no medication that works universally for all individuals without significant adverse effects. Knowledge, education and understanding are uppermost in management plans for tic disorders.
While pharmacological intervention is reserved for more severe symptoms, other treatments such as supportive psychotherapy or cognitive behavioral therapy may help to avoid or ameliorate depression and social isolation, and to improve family support.
Educating a patient, family, and surrounding community such as friends, school, and church is a key treatment strategy, and may be all that is required in mild cases. Medication is available to help when symptoms interfere with functioning.
Drugs from several other classes of medications can be used when stimulant trials fail, including guanfacine trade name Tenexatomoxetine Strattera and tricyclic antidepressants.
Clomipramine Anafranila tricyclic, and SSRIs —a class of antidepressants including fluoxetine Prozacsertraline Zoloftand fluvoxamine Luvox —may be prescribed when a Tourette's patient also has symptoms of obsessive—compulsive disorder. Several other medications have been tried, but evidence to support their use is unconvincing.
The majority of cases are mild and require no treatment.
The overall prognosis is positive, but a minority of children with Tourette syndrome have severe symptoms that persist into adulthood. Although the symptoms may be lifelong and chronic for some, the condition is not degenerative or life-threatening. Intelligence is normal in those with Tourette's, although there may be learning disabilities. The gene or genes associated with Tourette's have not been identified, and there is no potential "cure".
Tics may be at their highest severity at the time that they are diagnosed, and often improve with understanding of the condition by individuals and their families and friends. The statistical age of highest tic severity is typically between eight and twelve, with most individuals experiencing steadily declining tic severity as they pass through adolescence.
One study showed no correlation with tic severity and the onset of puberty, in contrast with the popular belief that tics increase at puberty.
In many cases, a complete remission of tic symptoms occurs after adolescence.