The following are in regard to notes taken while in-class, studying with Dr. Sonja Grover as the instructor of PSYCH 4418
Lecture 4- Tourettes Syndrome
Misperceiving Children with Tourettes as Behaviourally Disordered
-Children with Tourettes are often misperceived as having “behaviour problems” with teachers, parents and sometimes certain physicians not understanding that the behaviours are an involuntary symptom of a neurological disorder (since they have not considered the possibility of Tourettes as an underlying cause for the behavioural issues)
-Tourettes involves multiple tics i.e. of the face, arms, legs, or whole body etc. In stage two there are inarticulate noise or sound tics (they may accompany the nonvocal tics) and in stage three there are tics involving articulation of words on a repetitive basis and/or repeating other’s words (echolalia) or other’s behaviours (these meaningful vocalizations may accompany nonverbal behaviour tics) . Echolalia is not present for all children with Tourettes
-Hyperactivity and distractibility are also common associated features
-Older children may exhibit signs of depression, distress, and social anxiety due to the tics etc
-Younger children may be unaware of their symptoms and hence suffer no self-consciousness or distress
To be diagnosed with Tourettes AND Symptoms:
l “the child has to have multiple tics and vocal tics which can occur simultaneously or a different times in the course of the condition
l The tics occur many times a day and occur throughout one year with no period free of tic behaviours or vocalizations
l Onset is before 18 years old
l The tics are not due to the physiological effects of substances (i.e. stimulants) or another medical condition such as Huntington’s or post-viral encephalitis”
l In one-half of affected persons the tics start with a single simple tic (such as eye blinking most commonly)
l Less commonly, the condition can start with another part of the face or body i.e. head jerking
l Sometimes onset is with multiple tics occurring simultaneously
l The body part affected, severity, frequency, complexity and number of tics exhibited can vary dramatically over time for any individual with Tourettes
l Tourette’s used to be considered as invariably involving severe symptoms but now it is recognized that there can be a wide range in severity of symptoms exhibited from mild to severe depending on the individual affected
l Affects males more females
l Age of diagnosis is 2-15 years; median age is 7 years; usually diagnosed in childhood or adolescence (though some persons do not get a diagnosis until adulthood)
l By age 11 years almost all children with Tourettes have exhibited symptoms
l Prevalence is related to age-many more children (5-30 percent per 10,000) are affected than adults (1 to 2 per 10,000)
l It is known that children who have very severe obsessive-compulsive traits along with the tics are more difficult to treat pharmacologically
How it is Passed and Activated…
-If it is genetic, the tics vary from generation to generation\
- Identical twins may not have the same tics
-The severity of the tics may vary form generation to generation, but still depending on the amount of stress a person feels
-Tourettes may persist throughout the affected person’s lifetime though there may be periods of remission and these can last from weeks to years
-Most often the severity, frequency, disruptiveness and variability of the symptoms lessens significantly during adolescence and adulthood and some adults are symptom free
Tics (Verbal and Nonverbal Behavioural)
l 97% involve the head and face
l 80% involve the arms
l 55% involve the legs and body
l 30-40% of the affected have multiple tics
Simple vs. Complex Tics
l “Simple tics are rapid, repetitive meaningless contractions of one or a few muscles i.e. eye blinking”
l “Complex motor tics involve i.e touching, squatting, deep knee bends retracing steps, twirling when walking etc”.
l “Vocal tics i.e. coughing, grunts, yelps, sniffs, snorts, throat clearing etc”
l Coprolalia –complex vocal tic-compulsive involuntary uttering of obscenities- occurs in less than 10% of cases and one-third of these cease spontaneously
l A high percentage of persons with Tourettes do not seek medical attention for the tics and in those cases the tics are usually manageable less severe tics
l Others have very severe tics that interfere with daily activities and social interactions and these affected individuals may be forced to seek medical attention
l In severe Tourettes, the tics can interfere with reading, writing and other daily activities
No comments:
Post a Comment