Tic disorders


Tic disorders

Description tic disorders

Tics are described as repetitive, nonrhythmic, will partly be influenced, flicks (or vocalisation), which have no purpose and are not subject to any neurological disorder.

Manifestation tick can be virtually any movement or sound that the human body is able to issue a specific individual. Tics are compulsive character, people who suffer from them tend to have unpleasant feelings until implementation. Followed relief for various periods.

According molds are divided into motor tics (motion) and voice (voice), both groups even atsimple (plain) and complex.

Simple motor tics

They affect only one muscle group. They tend to be stereotyped repetitive short-term movementsškubavého character (clonic) or slower and writhing movements (dystonic). Clonic manifestations are most often winks, wrinkling his nose, nostrils twitching, jerking and twitching lips of various facial muscles, this includes jolting his head. Among dystonic ranks pinching the eyelid, rolling movements of the eyeballs, opening and twisting his mouth, appreciating and gnashing of teeth, twisting the neck and shoulders, isolated contractions of the abdominal muscles or other muscle groups.

Complex motor tics

They consist of a sequence of coordinated movements caused several muscle groups often resemble the movements in ordinary life, gesture, but with significant intensity and frequent repetition. It is an inappropriate swinging torso, head tossing, throwing strand of hair out of your eye, straightening her glasses, adjusting clothing or hairstyle; ohmatávání, sniffing and grasping objects, hitting, kicking, bouncing, jumps, spins and rolls during the walk. If implemented gestures handling of the genitals or anus talking about kopropraxii. If you follow the acts of another person, we called theechopraxií.

Simple vocal tics

They are motor tics involving the vocal tract – respiratory, laryngeal, oral and pharyngeal muscles.This forms a simple inarticulate sounds like snorting nose, coughing, grunting, belching, wheezing, sucking. For some people with vocal tics manifested in a very unnatural to inhuman scream, screaming and whistling.

Complex vocal tics

They consist of words or their fragments, which often contain some meaning, often inappropriate and offensive nature. Ranting inappropriate or even obscene words is called coprolalia. These cries coming out of context and situation of the victim’s personality, and yet even with much higher volumes. The more stupid and most appropriate expression in the patient company produces, the greater is the subsequent relief after the tick. Sometimes this type of tick manifested as called.Echolalia – repeating over others, or as palilálie – repeating his own statements, perhaps only the last syllable or part of the sentence.

Tic disorder is a very limited extent influenced by the will, but at considerable mental effort, internal tension and the discomfort it can be overridden. The pursuit of greater repression tick eg. School, a cinema, a concert will be called. Rebound – a significant discharge of accumulated tics. Some affected indicate alleviate the urge during mental activity and concentration, while under stress and arousal disorder highlights. Likewise highlighted during boring activities, or in hot weather. All types may persist even in sleep.

Clinically distinguish three forms:

Tic disorder – the disease lasts up to one year, appear particularly simple motor tics. Often manifests itself during childhood and ends with complete recovery.

The next stage is chronic motor / vocal tic disorder, which appear with all the above mentioned types of tics, lasting for several months and the progress is very stable.

The last type is the combined vocal and multiple tic disorder – syndrome de la Tourette (George Gilles de la Tourette first described in 1885, several cases). The syndrome manifests multiple complex tics of both types may occur echolalia and coprolalia. Some patients have very complicated speech, reminiscent of rituals. Some children is reflected together with Tourette syndrome have hyperactive disorder (ADHD) or obsessive-compulsive (OCD). Some patients also have sebepoškozovací tendency to suffer from anxiety and depression. All tic disorders occur in childhood, between 4 to 7 year, a rare achievement after 20 years.

Diagnosis tic disorders

The diagnosis of tic disorder is determined on the basis of an interview and medical history of the patient, followed by clinical observations of specific manifestations. Characteristic is the discovery younger than 21 Examination by imaging methods is also possible, but to determine the presence of a fault is not needed. Performed NMR (magnetic resonance imaging) and SPECT. In the future it may be possible genetic testing.

From the above mentioned disorders must be distinguished tics in congenital brain injury, Huntington’s disease, autism and drug-induced tics (methylphenidate, amphetamines).

Treatment of tic disorders

Tic disorder occurs most often around 4 years of age and is usually not serious, due to its short duration of pharmacologically treated. In other forms of the drug are already enjoying. In the first phase were tested benzodiazepines (clonazepam), this therapy is less effective. When the failure is used neuroleptics (haloperidol, pimozide, tiapride, risperidone). For those with hyperactive disorders used yet known. Α2 adrenergic receptor agonists (clonidine)

How can I help myself

Given that this is a very complex fault signaling between brain structures, and sometimes a hereditary disease development affected even inside the uterus, can not avoid this problem. The only way to prevent social complications is insufficient education of the population in the outlook for these patients. For children suffering in mainstream schools are advised private individual training or education within psychiatric facilities.

Complications tic disorders

Medical complications are associated mainly with those affected, who are prone to self-injury and can then cause serious injuries. Another significant group of health problems form the side effects of neuroleptics, which are, for example, significant depression, movement disorders, low blood pressure, dry mouth, weight gain.

Most, however, are expressed in social problems. It is většinopu children and young adults who may twitch or due to their outcries suffer from feelings of inferiority, social phobias and possibly bullying (mobbing). Intelligence is usually not significantly reduced and are no exception, patients with higher education.

 

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