Tic.
Tics are involuntary, sudden, abrupt, isolated, short (motor tics) sounds
produced by the nose, mouth or cheek (vocal tics, phonatory) or sensation (sensory
tics). Motor tics may be sempÍici (eg. Eye closure, twitching of the nose, head
shot) or complex (eg. Touching repetitive movements, jumps, kicks, pelvic
rotation). Similarly, vocal tics / phonatory may be simple (eg. Throat clearing,
grunting, vacuum) or complex (eg. Echolalia, palilalia, coprolalia)
Tics can be, therefore, of various types:
Motor tics (the most common, was sudden and short. In addition to those reported
previously recalled the various myoclonus.)
Vocal tics (the emission of unwanted sounds. Includes grunts, words spoken
without intention, etc.).
Tic behavior (echolalia, coprolalia, and so on.
Besides those there are other main types:
Tic dystonia (a series of coordinated movements with a presumed but nonexistent
end, eg. Jump)
Tic sensitive (when it is triggered by an external stimulation, often found in
people with Tourette's syndrome)
Tic transient (detectable in infancy)
The characteristics of tics include sopprimibilità, the raise in terms of stress
and restlessness, reduced with distraction and concentration, suggestibility,
the variability in the entity and a possible persistence during sleep. The most
common cause of tics is GiIIes de la Tourette's syndrome, a genetic disease
dominated by tics and a variety of behavioral manifestations. Transient
childhood tics and simple tics are likely to represent a persistent form of
fragmented de la Tourette syndrome.
The diagnostic criteria are as follows:
1. presence of multiple motor tics and one or more phonatory tics, but not both;
2. almost daily or intermittently for more than a year;
3. variability over time as regards anatomical location, number, frequency,
complexity, type and severity of tics;
4. onset before 21 years of age;
5. no other possible causes of involuntary movements and sounds.
Due to the fluctuation of heterogeneous and often bizarre events, the affected
patients often have an incorrect medical diagnosis and are abused by teachers,
teachers, colleagues and strangers. Epidemiological studies suggest that most
deicasi de la Tourette's syndrome have a genetic basis, using commonly with a
penetrance of approximately 100%, especially in males. In a few cases I'origine
can not be genetically triggered or caused by neuroleptics, carbon monoxide
poisoning, head trauma, viral encephalitis, cocaine and opiate withdrawal. Many
patients also suffer from an obsessive-compulsive disorder and have problems
with attention and learning. Sleep disorders include parasomnias, I'enuresi and
awakening as a result of the tics.
.
Treatment is varied. Since many patients experience the raise and fall of
symptoms and a generally favorable natural course, in cases of average severity
may be sufficient assurances and behavioral therapy. The drugs are indicated
when the tics are causing physical discomfort or social embarrassment. The
effective use of drugs blocking dopamine receptors, such as fluphenazine,
pimozide and haloperidol can reduce the frequency and severity of the tics and
improve the behavior of impulsive and aggressive. These drugs, however, cause
sedation, depression and weight gain. In addition, tardive dyskinesia is a
potentially serious complication of chronic neuroleptic therapy. Clonazepam,
clonidine, fluoxetine and clomipramine appear to be particularly useful in the
treatment of obsessive compulsive disorder and other behavioral disorders often
associated with Tourette syndrome.
Tourette syndrome (TS) is a neurological disorder characterized by tics -
involuntary, rapid, sudden movements or vocalizations that occur repeatedly in
the same way. The diagnostic criteria are:
It DITIC multiple motor and / or more vocal tics present at any time, or not
necessarily at the same time;
The occurrence of tics many times a day (usually at times), almost every day or
intermittently throughout a period of more than one year;
periodic variations in the number, frequency, type and location of tics, and
waxing and waning of their severity. Symptoms can sometimes disappear for weeks
or months at a time, onset before age 18.
Although the word "involuntary" is used to describe the nature of tics, this is
not entirely accurate. It is incorrect to say that people with TS have
absolutely no control over their tics, as if it were some kind of spasm, rather,
a more appropriate term would be. "Exciting" People with TS feel an irresistible
need to perform their tics, such as the need to scratch a mosquito bite. Some
people with TS are able to hold the tics a few hours, but this only leads to a
huge explosion of tics once they are finally allowed to be expressed.
Coprolalia must not only be understood as uttering profanity or swear words
automatically. Many times the words expressing coprolalia manifests itself
socially inappropriate or unacceptable.
What causes Tourette syndrome?
The search is ongoing, but it is believed that an altered metabolism of the
neurotransmitters dopamine and serotonin are involved with the disease. It is
genetically transmitted; parents with a 50% chance of passing the gene to their
children. Girls with the gene have a 70% chance of symptoms, while boys with the
gene have a 99% chance of displaying symptoms.
Myoclonus
Myoclonus is a movement similar to a click produced by a sudden contraction,
rapid and brief (positive myoclonus) or muscle inhibition (negative myoclonus).
Segmental myoclonus usually involves the origin of gill structures, innervated
by the last cranial nerves and upper cervical nerve roots, consists of rhythmic
contractions (I to 3 Hz) caused by a lesion of the midbrain or spinal cord.
Palatal myoclonus resulting from acute or chronic injuries involving anatomical
triangle between the dentate nucleus, red nucleus and inferior olivary nucleus.
The generalized myoclonus is considered to reflect a departure from the shock of
the midbrain reticular formation and is divided into physiological, essential,
epileptic, or symptomatic. Two forms of myoclonus are associated with sleep
myoclonus physiology of sleep, which usually occurs in the early stages of sleep,
and nocturnal myoclonus, which is currently defined as "periodic movements of
sleep, often associated with" restless leg syndrome "as also to abnormal
involuntary movements during wakefulness.
The causes of generalized myoclonus include acute and prolonged hypoxia and
ischemia, several metabolic factors, infectious and toxic I'assunzione of
neuroleptic drugs (myoclonus late). The myoclonus may be associated with chorea
family to dystonia and many neurodegenerative diseases, including Parkinson's
disease, progressive myoclonic I'epilessia and a range of rare diseases
eredodegenerative. Multifocal myoclonus often occurs in the late stages of
Creutzfeldt-Jakob disease, and, less frequently, in Alzheimer's disease.
The specific pathogenesis of myoclonus are unknown. Studies have shown that
clonazepam, lorazepam, valproate, carbamazepine and 5-hydroxytryptophan
antimioclonica own activities. Clonazepam, at a dose of 1 a9 mg / day, is the
drug of first choice but the development of side effects such as drowsiness,
ataxia, and sexual problems often limit their use.
Stereo
The term "stereo" means a continuous motion or intermittent, involuntary,
coordinated, stereotyped, repetitive, rhythmic aimless, but apparently finalized
and ritual. The stereotypes can be simple (eg. Chewing movements, stomping,
swinging the body) or complex (es.rituali complicated, and sit up from a chair).
Can be suppressed voluntarily. The stereotypes may accompany a variety of
behavioral disorders in humans such as anxiety disorder, obsessive-compulsive
disorder, Tourette's syndrome to, schizophrenia, akathisia, I'autismo and mental
retardation. The stereotypes and self-stimulatory behavior and self-harm are the
most recognizable symptoms in patients with mental retardation and autism.
In tardive dyskinesia, a persistent disorder of movement caused by drugs
blocking the receptors for dopamine, there is frequently the stereo. Many other
problems can arise dalI'uso late movement of the dopamine receptor blocking
drugs (neuroleptics). The term describes a combination of akathisia and
stereotypy seen as a sensory component inner feeling of restlessness. The
disorder affects especially the lower extremities ("Restless Legs") and is often
worse at night, causing insomnia, and may be associated with periodic movements
in sleep. Older women appear to be particularly at risk for tardive dyskinesia.
The pathological mechanism is unknown but is considered by the development of
hypersensitivity of dopamine receptors caused by chronic blockade by
neuroleptics. Prevention is the best treatment for drug-induced movement
disorders. When possible, psychiatric disorders or gastrointestinal drugs should
be used other than neuroleptics. When there is no alternative, the dosage and
duration of administration should be minimized. The spontaneous tardive
dyskinesia occasionally follows the suspension of the causative agent. Depletori
dopamine drugs, such as tetrabenazine or reserpine, are most effective as a
symptomatic treatment.
.......
>>>see first page
>>>see also RICERCA