Management of Tourette syndrome: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous editNext edit →
Content deleted Content added
VisualWikitext
fix
Line 359: Line 359:
==Notes==
==Notes==
{{reflist|2}}
{{reflist|2}}

=== Book sources ===
* [[Donald J. Cohen|Cohen DJ]], [[Joseph Jankovic|Jankovic J]], Goetz CG, eds (2001). ''Advances in Neurology, Tourette Syndrome''. '''85'''. Philadelphia, PA: Lippincott, Williams & Wilkins. {{isbn|0-7817-2405-8}}
* {{cite book |author= Kushner HI |title= A Cursing Brain?: The Histories of Tourette Syndrome |publisher= [[Harvard University Press]] |date= 2000 |isbn= 0-674-00386-1}}
* [[James F. Leckman|Leckman JF]], [[Donald J. Cohen|Cohen DJ]] (1999). ''Tourette's Syndrome—Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care''. John Wiley & Sons, Inc., New York. {{ISBN|0-471-16037-7}}
* Martino D, Leckman JF, eds (2013). ''Tourette syndrome''. Oxford University Press. {{ISBN|978-0199796267}}.
**Bloch MH (2013). "Clinical course and adult outcome in Tourette syndrome". In Martino D, Leckman JF, eds. ''Tourette syndrome''. Oxford University Press. pp. 107–20.
**Müller-Vahl KR (2013). "Information and social support for patients and families". In Martino D, Leckman JF, eds. ''Tourette syndrome''. Oxford University Press. pp. 623–35.
**Pruitt SK, Packer LE (2013). "Information and support for educators". In Martino D, Leckman JF, eds. ''Tourette syndrome''. Oxford University Press. pp. 636–55.
* Sukhodolsky DG, Gladstone TR, Kaushal SA, Piasecka JB, [[James F. Leckman|Leckman JF]] (2017). "Tics and Tourette Syndrome". In Matson JL, ed. ''Handbook of Childhood Psychopathology and Developmental Disabilities Treatment''. Autism and Child Psychopathology Series. Springer. pp. 241–56. {{doi|10.1007/978-3-319-71210-9_14}}.


== External links ==
== External links ==

Revision as of 22:30, 26 February 2020

Tourette syndrome (abbreviated as Tourette's or TS) is an inherited [[neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of motor and phonic tics. The management of Tourette syndrome has the goal of managing symptoms to achieve optimum functioning, rather than eliminating symptoms; not all persons with Tourette's require treatment, and there is no cure or universally effective medication.[1][2][3] Explanation and reassurance alone are often sufficient treatment;[2] education is an important part of any treatment plan.[4]

Tourette syndrome patients may exhibit symptoms of other comorbid conditions along with their motor and phonic tics. Associated conditions include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), learning disabilities and sleep disorders.[3] Patients who have ADHD along with Tourette's may also have problems with disruptive behaviors, overall functioning, and cognitive function. Co-occurring OCD can also be a source of impairment, necessitating treatment. Not all persons with tics will also have other conditions and not all persons with tics require treatment, but when comorbid disorders are present, they often require treatment.

Management priority

Management of Tourette syndrome can be divided into treatment of tics, and treatment of co-occurring conditions, which, when present, are often a larger source of functional impairment than the tics themselves.[5]

There is no cure for Tourette's.[6] No one medication effectively treats all symptoms, most medications prescribed for tics have not been approved for that use, and no medication is without the risk of significant adverse effects.[7][8][9] Treatment is focused on identifying the most troubling or impairing symptoms and helping the individual manage them.[8] Because comorbid conditions are often a larger source of impairment than tics,[5] they are a priority in treatment.[10] The management of Tourette's is individualized and involves shared decision-making between the clinician, patient, family and caregivers.[10][11] Practice guidelines for the treatment of tics were published by the American Academy of Neurology in 2019.[10]

Education, reassurance and psychobehavioral therapy are often sufficient for the majority of cases.[12][8][13][14] In particular, psychoeducation targeting the patient and their family and surrounding community is a key management strategy.[15] Watchful waiting "is an acceptable approach" for those who are not functionally impaired.[10] Symptom management may include behavioral, psychological and pharmacological therapies. Pharmacological intervention is reserved for more severe symptoms, while psychotherapy or cognitive behavioral therapy (CBT) may ameliorate depression and social isolation, and improve family support.[8] The decision to use behavioral or pharmacological treatment is "usually made after the educational and supportive interventions have been in place for a period of months, and it is clear that the tic symptoms are persistently severe and are themselves a source of impairment in terms of self-esteem, relationships with the family or peers, or school performance".[16]

Psychoeducation and social support

Knowledge, education and understanding are uppermost in management plans for tic disorders,[8] and psychoeducation is the first step.[17] A child's parents are typically the first to notice their tics;[18] they may feel worried, imagine that they are somehow responsible, or feel burdened by misinformation about Tourette's.[17] Before seeing a doctor, many parents research TS on the internet,[19] or have seen media portrayals of severe cases.[20] Parents may be overly concerned,[19] and not realize that they, too, have tics, while the child may not be bothered by the tics.[17] In some cases, neither the parents nor their child know they are ticcing; pointing out tics in this case will unnecessarily draw attention to them. In such a case, informing a parent who is unaware of their own tics can be disturbing, and they have a "right not to be informed".[17] When their child receives a diagnosis of Tourette syndrome, both parent and child usually feel relieved, although the diagnosis can also cause distress for the parents as they confront a chronic condition that can be difficult to treat.[17] Effectively educating parents about the diagnosis and providing social support can ease their anxiety. This support can also lower the chance that their child will be unnecessarily medicated[19] or experience an exacerbation of tics due to their parents' emotional state.[21] Psychoeducation that encourages a "matter-of-fact" attitude, and helps dispel misconceptions and stigma, is most effective when provided to parents.[21]

People with Tourette's may suffer socially if their tics are viewed as "bizarre". If a child has disabling tics, or tics that interfere with social or academic functioning, supportive psychotherapy or school accommodations can be helpful.[22] Even children with milder tics may be angry, depressed or have low self-esteem as a result of increased teasing, bullying, rejection by peers or social stigmatization, and this can lead to social withdrawal. Some children feel empowered by presenting a peer awareness program to their classmates.[23][11][24] It can be helpful to educate teachers and school staff about typical tics, how they fluctuate during the day, how they impact the child, and how to distinguish tics from naughty behavior. By learning to identify tics, adults can refrain from asking or expecting a child to stop ticcing,[25] [24]because "tic suppression can be exhausting, unpleasant, and attention-demanding and can result in a susequent rebound bout of tics".[25] The presence of ADHD is associated with functional impairment, disruptive behavior, and tic severity.[26] Strategies to help the child at school can be established; these include allowing the child to chew gum to help reduce vocal tics, to use a laptop instead of writing by hand, and to take breaks from the classroom when tics are high. Providing additional test time can also be helpful, as can using oral tests when needed.[25]

Adults with TS may withdraw socially to avoid stigmatization and discrimination because of their tics.[20] Depending on their country's healthcare system, they may receive social services or help from support groups.[27]

Behavioral

Behavioral therapies using habit reversal training (HRT) and exposure and response prevention (ERP) are first-line interventions,[28] and have been shown effective.[29] When an individual is aware of the premonitory urge that precedes a tic, and because tics are somewhat suppressible, individuals can be trained to develop a response to the urge that competes with the tic.[30][28] Comprehensive behavioral intervention for tics (CBIT) is based on HRT, which is the best researched behavioral therapy for tics.[28] With a high level of confidence, CBIT has been shown to be more likely to lead to a reduction in tics than other supportive therapies or psychoeducation.[7]

Some limitations are: children younger than ten may not understand the treatment, people with severe tics or ADHD may not be able to suppress their tics or sustain the required focus to benefit from behavioral treatments, there is a lack of therapists trained in behavioral interventions,[31] finding practitioners outside of specialty clinics can be difficult,[29] and costs may limit accessibility.[28] Whether increased awareness of tics through HRT/CBIT (as opposed to moving attention away from them) leads to further increases in tics later in life is a subject of discussion among TS experts.[28]

When comorbid disruptive behaviors exist, anger control training and parent training can be effective.[32][33] CBT is a useful treatment when OCD is present.[30] Relaxation techniques, such as exercise, yoga or meditation, may be useful in relieving the stress that may aggravate tics, but the majority of behavioral interventions (such as relaxation training and biofeedback, with the exception of habit reversal) have not been systematically evaluated and are not empirically supported therapies for Tourette's.[34]

Massed negative practice, biofeedback, relaxation, hypnosis and other behavioral approaches are proposed as alternative treatments of tics, but few have been well assessed.[35] Relaxation techniques, such as exercise, yoga or meditation, may be useful in relieving stress that may aggravate tics, but the majority of behavioral interventions (such as relaxation training and biofeedback, with the exception of habit reversal) have not been systematically evaluated and are not proven therapies for Tourette's.[36]

Medication

Space-filling representation of a haloperidol molecule. Haloperidol is an antipsychotic medication sometimes used to treat severe cases of Tourette's.

There are no medications specifically designed to target tics, although some antipsychotics (for example, pimozide) have been FDA-approved for treating Tourette's. Medications which are used as primary treatment in other conditions are used with some success in treating tics. Neuroleptic medications (antipsychotics), such as haloperidol (brand name Haldol) or pimozide (brand name Orap), have historically been and continue to be the medications with the most proven efficacy in controlling tics. These medications work by blocking dopamine receptors, and are associated with a high side effect profile. The traditional antipsychotic drugs are associated with tardive dyskinesia when used long-term; and parkinsonism, dystonia, dyskinesia, and akathisia when used short-term. Additional side effects can be school phobia (a form of separation anxiety), depression, weight gain, and cognitive blunting (dulling of cognitive ability). Another traditional antipsychotic used in treating Tourette's is fluphenazine (brand name Prolixin), although the evidence supporting its use is less than that of haloperidol and pimozide.[5]

The classes of medication with proven efficacy in treating tics—typical and atypical neuroleptics—can have long-term and short-term adverse effects.[5] The antihypertensive agents are also used to treat tics; studies show variable efficacy, but a lower side effect profile than the neuroleptics.[37] There is moderate evidence that the antihypertensive clonidine, along with aripiprazole, haloperidol, risperidone, and tiapride, reduce tics more than placebo.[7] Aripiprazole and risperidone are likely to lead to weight gain and sedation or fatigue; haloperidol may increase prolactin levels; tiapride may produce sleep disturbances and tiredness; and clonidine may produce sedation. Risperidone and haloperidol may produce extrapyramidal symptoms.[7]

Newer neuroleptics, the atypical neuroleptics, are an alternative to the traditional medications used for treating tics. These medications have more selective dopamine blocking effects, or block serotonin with some blocking of dopamine. The medications in this class used to treat tics include risperidone (brand name Risperdal), olanzapine (brand name Zyprexa), ziprasidone (brand name Geodon), quetiapine (brand name Seroquel), clozapine (brand name Clozaril), tiapride, and sulpiride. They seem to have lower risks of neurological side effects (such as tardive dyskinesia) when used short-term, but longer trials are needed to confirm this. Some of the side effects associated with these medications are insomnia, weight gain, and school phobia. Abnormalities in metabolism, cardiac conduction times, and increased risk of diabetes are concerns with these medications. There is good empirical support for the use of risperidone, and less support for the others.[5]

Clonidine (or the clonidine patch) is one of the medications typically tried first when medication is needed for Tourette's.

The α2-adrenergic receptor agonists (antihypertensive agents) show some efficacy in reducing tics, as well as other comorbid features of some people with Tourette's. Originally developed to treat high blood pressure, these medications are a safer alternative to neuroleptic medications for the people with TS that respond to them. This class of medication is often the first tried for tics, as the antihypertensives have a lower side effect profile than some of the medications which more proven efficacy. The evidence for their safety and efficacy is not as strong as the evidence for some of the standard and atypical neuroleptics, but there is fair supportive evidence for their use, nonetheless.[38] This class of medication takes about six weeks to begin to work on tics, so sustained trials are warranted. Because of the blood pressure effects, antihypertensive agents should not be discontinued suddenly. Clonidine (brand name Catapres) works on tics for about half of people with TS.[39][40] Maximal benefit may not be achieved for 4–6 months. A small number of patients may worsen on clonidine.[41] Guanfacine (brand name Tenex) is another antihypertensive that is used in treating TS. Side effects can include sedation, dry mouth, fatigue, headaches and dizziness. Sedation can be problematic when treatment is first initiated, but may wear off as the patient adjusts to the medication.[5]

Other medications that can be used to treat tics include pergolide (brand name Permax), and with less empirical support for efficacy, tetrabenazine and baclofen.[5]

There is low to very low confidence that tics are reduced with baclofen, deprenyl, flutamide, guanfacine, mecamylamine, metoclopramide, ondansetron, pimozide, pramipexole, riluzole, tetrahydrocannabinol, topiramate, or ziprasidone.[7] There is insufficient evidence for other cannabis-based medications in the treatment of Tourette's.[10]

Clomipramine, a tricyclic, and SSRIs—a class of antidepressants including fluoxetine, sertraline, and fluvoxamine—may be prescribed when a Tourette's patient also has symptoms of obsessive–compulsive disorder.[5]

The benefits and harms of botulinum toxin for treating tics have not been established as of 2018.[42]

Treatment of ADHD in the presence of tic disorders

Stimulants (such as Adderall and Ritalin) are underused in the treatment of ADHD when tics are also present.

Patients with Tourette's who are referred to specialty clinics have a high rate of comorbid attention-deficit hyperactivity disorder (ADHD), so the treatment of ADHD co-occurring with tics is often part of the clinical treatment of Tourette's. Patients who have ADHD along with Tourette's may also have problems with disruptive behaviors, overall functioning, and cognitive function, accounted for by the comorbid ADHD, highlighting the importance of identifying and treating other conditions when present.[43]

Stimulants and other medications may be useful in treating ADHD when it co-occurs with tic disorders. Drugs from several other classes of medications can be used when stimulants fail.[5] There is moderate evidence supporting that clonidine combined with methylphenidate, desipramine, and methylphenidate alone reduce tics more than placebo when ADHD is also present; desipramine is rarely used following reports of sudden death in children.[7] Atomoxetine does not increase tics, but may lead to weight loss and an increased heart rate.[7]

The treatment of ADHD in the presence of tic disorders has long been a controversial topic. Past medical practice held that stimulants (such as Ritalin) could not be used in the presence of tics, due to concern that their use might worsen tics;[44] however, multiple lines of research have shown that stimulants can be cautiously used in the presence of tic disorders.[45] Several studies have shown that stimulants do not exacerbate tics any more than placebo does, and suggest that stimulants may even reduce tic severity.[46] Controversy remains, and the PDR continues to carry a warning that stimulants should not be used in the presence of tic disorders, so physicians may be reluctant to use them. Others are comfortable using them and even advocate for a stimulant trial when ADHD co-occurs with tics, because the symptoms of ADHD can be more impairing than tics.[2][44]

The stimulants are the first line of treatment for ADHD, with proven efficacy, but they do fail in up to 20% of cases, even in patients without tic disorders.[5] Current prescribed stimulant medications include: methylphenidate (brand names Ritalin, Metadate, Concerta), dextroamphetamine (Dexedrine), and mixed amphetamine salts (Adderall). Other medications can be used when stimulants are not an option. These include the alpha-2 agonists (clonidine and guanfacine), tricyclic antidepressants (desipramine and nortriptyline), and newer antidepressants (bupropion, venlafaxine and atomoxetine). A retrospective case series published in 1993 suggested that treatment with bupropion (trade name Wellbutrin) can worsen tics,[47] but there is no data from placebo-controlled trials to support this.[48] There is good empirical support for the use of desipramine, bupropion and atomoxetine (brand name Strattera).[5] Atomoxetine is the only non-controlled Food and Drug Administration (FDA) approved drug for the treatment of ADHD, but is less effective than stimulants for ADHD, is associated with individual cases of liver damage, carries an FDA black box warning regarding suicidal ideation, and controlled studies show increases in heart rate, decreases of body weight, decreased appetite and treatment-emergent nausea.[49]

Other

Complementary and alternative medicine approaches, such as dietary modification, allergy testing and allergen control, and neurofeedback, have popular appeal, but no role has been proven for any of these in the treatment of Tourette syndrome.[50][51] While a balanced diet may aid in overall health, and avoidance of caffeine may help minimize tics for some children,[52] no particular diet or alternative therapy (vitamin or diet) is supported by scientific evidence.[50][35] As of 2018, in spite of no evidence base supporting dietary approaches to management of TS symptoms, anecdotal reports indicate that parents, caregivers, and individuals with TS are using dietary approaches and nutritional supplements nonetheless.[50]

Regular exercise can help reduce stress and improve a child's sense of accomplishment and self-esteem, but the effect of exercise on symptoms remains unstudied.[52]

Deep brain stimulation has been used to treat adults with severe Tourette's that does not respond to conventional treatment.[8][53][54] [55] The procedure is well tolerated, but complications include "short battery life, abrupt symptom worsening upon cessation of stimulation, hypomanic or manic conversion, and the significant time and effort involved in optimizing stimulation parameters".[56] Viswanathan A et al (2012) say that DBS should be used in patients with "severe functional impairment that can not be managed medically".[57] DBS has become a valid option for individuals with severe symptoms that do not respond to conventional therapy and management.[58][59] There is low-quality, limited evidence that DBS is safe, well tolerated, and yields symptom reduction ranging from no change to complete remission.[58] Selecting candidates who may benefit from DBS is challenging, and "age, tic severity, and treatment refractoriness are important factors to consider", according to Fraint and Pal (2016).[59] The ideal brain location to target has not been identified as of 2016.[58][59][60]

Practice guidelines

In 2019, the American Academy of Neurology (AAN) published practice guidelines, "Treatment of tics in people with Tourette syndrome and chronic tic disorders", including 46 recommendations based on a systematic review by nine physicians, two psychologists, and two patient representatives. The panel assigned three levels of recommendations corresponding to the strength of the evidence supporting the recommendation:[10]

  • A: "rare because they are based on high confidence in the evidence and require both a high magnitude of benefit and low risk".
  • B: "common because the requirements are less stringent but still based on the evidence and benefit–risk profile".
  • C: "lowest allowable recommendation level that the AAN considers useful within the scope of clinical practice and accommodates the highest degree of practice variation".

The panel attached a helping verb to each level of recommendation: A = must; B = should, and C = may.[10]

Description Recommendation per American Academy of Neurology 2019 practice guidelines[10] Clinicians
A: Must B: Should C: May
Counseling Inform individuals and caregivers about the natural course of tic disorders
checkY
Counseling Evaluate tic-related impairment in functioning
checkY
Counseling Inform about watchful waiting for those who do not experience impairment
checkY
Counseling Initially prescribe Comprehensive Behavioral Intervention for Tics (CBIT) for those who are motivated and without functional impairment
checkY
Counseling Periodically re-evaluate need for any prescribed medications for tics
checkY
Psychoeducation Refer teachers and peers to resources for education about TS
checkY
ADHD assessment and management Assess for comorbid ADHD
checkY
ADHD assessment and management Evaluate impairment from symptoms of ADHD
checkY
ADHD assessment and management Ensure ADHD is treated when it is causing impairment
checkY
OCD assessment and management Assess for comorbid OCD
checkY
OCD assessment and management Ensure OCD is treated when it is present
checkY
Other comorbid disorders Screen for comorbid anxiety, mood, and disruptive behavior disorders
checkY
Other comorbid disorders Inquire about suicidal ideation and recommend resources if present
checkY
Tic severity assessment Measure severity of tics using a validated assessment scale
checkY
Treatment expectations Inform that treating tics rarely leads to complete cessation of tics
checkY
Behavioral treatments For those who have access to it, prescribe CBIT initially relative to other behavioral interventions
checkY
Behavioral treatments Offer CBIT initially relative to medication
checkY
Behavioral treatments If face-to-face CBIT is not available, prescribe CBIT via Internet, or prescribe other behavioral interventions
checkY
α agonist treatment Inform individuals with comorbid ADHD that α2 agonists may treat both tics and ADHD
checkY
α agonist treatment Prescribe α2 agonists when benefits outweigh risks
checkY
α agonist treatment Inform individuals treated about side effects of α2 agonists
checkY
α agonist treatment In those treated with α2 agonists, monitor heart rate and blood pressure
checkY
α agonist treatment For those taking extended release guanfacine, monitor QTc interval as indicated
checkY
α agonist treatment Gradually taper α2 agonists when discontinuing them
checkY
Antipsychotic treatment Prescribe antipsychotics when benefit outweighs risks
checkY
Antipsychotic treatment Inform patients about adverse effects (extrapyramidal, hormonal, and metabolic) of antipsychotics
checkY
Antipsychotic treatment Prescribe lowest effective dosage of antipsychotics when using them
checkY
Antipsychotic treatment When using antipsychotics, use evidence-based monitoring for drug-induced movement disorders and adverse effects
checkY
Antipsychotic treatment When prescribing certain antipsychotics, monitor QTc interval and perform elecrocardiography
checkY
Antipsychotic treatment Gradually taper (over weeks to months) antipsychotics when discontinuing
checkY
Botulinum toxin injections Prescribe botulinum toxin injections for localized simple motor tics to adolescents and adults when benefits outweigh risks
checkY
Botulinum toxin injections Prescribe botulinum toxin injections for aggressive or disabling vocal tics to adolescents and adults when benefits outweigh risks
checkY
Botulinum toxin injections Inform individuals that temporary effects of botulinum toxin injections of hypophonia and weakness may occur
checkY
Topiramate treatment Prescribe topiramate when benefits outweigh risks
checkY
Topiramate treatment Inform individuals when prescribing topiramate of adverse effects
checkY
Cannabis-based treatment When individuals are using cannabis as self-medication for tics, direct them to appropriate medical supervision
checkY
Cannabis-based treatment For "treatment-resistant adults with clinically relevant tics", consider cannabis-based products where legislation permits it.
checkY
Cannabis-based treatment For adults who already self-medicate tics with cannabis-based products, consider cannabis-based medication where legislation permits it.
checkY
Cannabis-based treatment When prescribing cannabis-products where legislation permits it, use lowest effective dose
checkY
Cannabis-based treatment When prescribing, inform individuals that cannabis-based products can affect driving
checkY
Cannabis-based treatment When prescribing, provide ongoing re-evaluation of need
checkY
Deep brain stimulation treatment Employ multidisciplinary evaluation of benefits versus risks
checkY
Deep brain stimulation treatment Exclude secondary causes of tic-like movements and confirm TS diagnosis when considering deep brain stimulation
checkY
Deep brain stimulation treatment Screen for psychiatric disorders and follow deep brain stimulation subjects post-operatively
checkY
Deep brain stimulation treatment Before prescribing, assure that multiple classes of medications have been tried
checkY
Deep brain stimulation treatment Consider deep brain stimulation for "severe, self-injurious tics"
checkY

Notes

  1. ^ Schapiro NA. "Dude, you don't have Tourette's": Tourette's syndrome, beyond the tics. Pediatr Nurs. 2002 May–Jun;28(3):243–6, 249-53. PMID 12087644
  2. ^ a b c Zinner SH. Tourette disorder. Pediatr Rev. 2000;21(11):372–383. PMID 11077021
  3. ^ a b Tourette Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke/National Institutes of Health (NINDS/NIH), February 14, 2007. Retrieved on May 14, 2007.
  4. ^ Peterson BS, Cohen DJ. The Treatment of Tourette's Syndrome: Multimodal, Developmental Intervention. J Clin Psychiatry. 1998;59 Suppl 1:62–72; discussion 73–4. PMID 9448671 Full text, archived May 25, 1998. "Because of the understanding and hope that it provides, education is also the single most important treatment modality that we have in TS."
  5. ^ a b c d e f g h i j k Scahill L, Erenberg G, Berlin CM Jr, Budman C, Coffey BJ, Jankovic J, Kiessling L, King RA, Kurlan R, Lang A, Mink J, Murphy T, Zinner S, Walkup J; Tourette Syndrome Association Medical Advisory Board: Practice Committee. Contemporary assessment and pharmacotherapy of Tourette syndrome (PDF). NeuroRx. 2006 Apr;3(2):192–206. doi:10.1016/j.nurx.2006.01.009 PMID 16554257
  6. ^ Morand-Beaulieu S, Leclerc JB (January 2020). "[Tourette syndrome: Research challenges to improve clinical practice]". Encephale (in French). doi:10.1016/j.encep.2019.10.002. PMID 32014239.
  7. ^ a b c d e f g Pringsheim T, Holler-Managan Y, Okun MS, et al. (May 2019). "Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders". Neurology (Review). 92 (19): 907–15. doi:10.1212/WNL.0000000000007467. PMID 31061209.
  8. ^ a b c d e f Singer HS. "Tourette syndrome and other tic disorders". Handb Clin Neurol. 2011;100:641–57. doi:10.1016/B978-0-444-52014-2.00046-X PMID 21496613. Also see Singer HS. "Tourette's syndrome: from behaviour to biology". Lancet Neurol. 2005 Mar;4(3):149–59. doi:10.1016/S1474-4422(05)01012-4 PMID 15721825.
  9. ^ "Tourette syndrome treatments". U.S. Centers for Disease Control and Prevention (CDC). 2019. Retrieved February 26, 2020.
  10. ^ a b c d e f g h Pringsheim T, Okun MS, Müller-Vahl K, et al. (May 2019). "Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders". Neurology (Review). 92 (19): 896–906. doi:10.1212/WNL.0000000000007466. PMC 6537133. PMID 31061208. Cite error: The named reference "Pringsheim2019" was defined multiple times with different content (see the help page).
  11. ^ a b Müller-Vahl KR (2013) in Martino D, Leckman JF, eds, p. 628.
  12. ^ Stern JS (August 2018). "Tourette's syndrome and its borderland" (PDF). Pract Neurol (Historical review). 18 (4): 262–70. doi:10.1136/practneurol-2017-001755. PMID 29636375.
  13. ^ Stern JS, Burza S, Robertson MM (January 2005). "Gilles de la Tourette's syndrome and its impact in the UK". Postgrad Med J (Review). 81 (951): 12–19. doi:10.1136/pgmj.2004.023614. PMC 1743178. PMID 15640424.
  14. ^ Peterson BS, Cohen DJ (1998). "The treatment of Tourette's syndrome: multimodal, developmental intervention". J Clin Psychiatry (Review). 59 (Suppl 1): 62–74. PMID 9448671. Because of the understanding and hope that it provides, education is also the single most important treatment modality that we have in TS. Also see Zinner 2000, PMID 11077021.
  15. ^ Robertson MM (March 2000). "Tourette syndrome, associated conditions and the complexities of treatment" (PDF). Brain (Review). 123 (Pt 3): 425–62. doi:10.1093/brain/123.3.425. PMID 10686169. Archived from the original (PDF) on June 14, 2007.
  16. ^ Sukhodolsky, et al (2017), p. 248.
  17. ^ a b c d e Müller-Vahl KR (2013) in Martino D, Leckman JF, eds, pp. 623–24.
  18. ^ Cite error: The named reference Muller625 was invoked but never defined (see the help page).
  19. ^ a b c Müller-Vahl KR (2013) in Martino D, Leckman JF, eds, p. 626. "Quite often, the unimpaired child receives medical treatment to reduce tics, when instead the parents should more appropriately receive psychoeducation and social support to better cope with the condition."
  20. ^ a b Müller-Vahl KR (2013) in Martino D, Leckman JF, eds, p. 627.
  21. ^ a b Cite error: The named reference Martino2018 was invoked but never defined (see the help page).
  22. ^ Cite error: The named reference WhatisTS was invoked but never defined (see the help page).
  23. ^ Cite error: The named reference Efron2018 was invoked but never defined (see the help page).
  24. ^ a b Pruitt SK & Packer LE (2013) in Martino D, Leckman JF, eds, pp. 646–47.
  25. ^ a b c Muller-Vahl KR (2013) in Martino D, Leckman JF, eds, p. 629.
  26. ^ Robertson MM (November 2008). "The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 2: tentative explanations for differing prevalence figures in GTS, including the possible effects of psychopathology, aetiology, cultural differences, and differing phenotypes". J Psychosom Res (Comparative study). 65 (5): 473–86. doi:10.1016/j.jpsychores.2008.03.007. PMID 18940378.
  27. ^ Müller-Vahl KR (2013) in Martino D, Leckman JF, eds, p. 633.
  28. ^ a b c d e Fründt O, Woods D, Ganos C (April 2017). "Behavioral therapy for Tourette syndrome and chronic tic disorders". Neurol Clin Pract (Review). 7 (2): 148–56. doi:10.1212/CPJ.0000000000000348. PMC 5669407. PMID 29185535.
  29. ^ a b Fernandez TV, State MW, Pittenger C (2018). "Tourette disorder and other tic disorders". Handb Clin Neurol (Review). 147: 343–54. doi:10.1016/B978-0-444-63233-3.00023-3. PMID 29325623.
  30. ^ a b Dale RC (December 2017). "Tics and Tourette: a clinical, pathophysiological and etiological review". Curr. Opin. Pediatr. (Review). 29 (6): 665–73. doi:10.1097/MOP.0000000000000546. PMID 28915150.
  31. ^ Ganos C, Martino D, Pringsheim T (2017). "Tics in the Pediatric Population: Pragmatic Management". Mov Disord Clin Pract (Review). 4 (2): 160–172. doi:10.1002/mdc3.12428. PMC 5396140. PMID 28451624.
  32. ^ Hollis C, Pennant M, Cuenca J, et al. (January 2016). "Clinical effectiveness and patient perspectives of different treatment strategies for tics in children and adolescents with Tourette syndrome: a systematic review and qualitative analysis". Health Technology Assessment. Southampton (UK): NIHR Journals Library. 20 (4): 1–450. doi:10.3310/hta20040. ISSN 1366-5278.
  33. ^ Sudhodolsky, et al (2017), p. 250.
  34. ^ Woods DW, Himle MB, Conelea CA (2006). "Behavior therapy: other interventions for tic disorders". Adv Neurol (Review). 99: 234–40. PMID 16536371.
  35. ^ a b Singer HS. "Tourette's syndrome: from behaviour to biology". Lancet Neurol. 2005 Mar;4(3):149–59. doi:10.1016/S1474-4422(05)01012-4 PMID 15721825
  36. ^ Woods DW, Himle MB, Conelea CA. Behavior therapy: other interventions for tic disorders. Adv Neurol. 2006;99:234–40. PMID 16536371
  37. ^ Schapiro NA (2002). ""Dude, you don't have Tourette's:" Tourette's syndrome, beyond the tics". Pediatr Nurs (Review). 28 (3): 243–46, 249–53. PMID 12087644. Archived from the original on 2008-12-05. See also Bloch, State, Pittenger (2011), PMID 21386676
  38. ^ Leckman JF, Hardin MT, Riddle MA, et al. Clonidine treatment of Gilles de la Tourette's syndrome. Arch Gen Psychiatry. 1991 Apr;48(4):324–8. PMID 2009034
  39. ^ Leckman JF, Cohen DJ, Detlor J, et al. Clonidine in the treatment of Tourette syndrome: a review of data. Adv Neurol. 1982;35:391–401. PMID 6756089
  40. ^ Leckman JF, Detlor J, Harcherik DF, et al. Short- and long-term treatment of Tourette's syndrome with clonidine: a clinical perspective. Neurology. 1985 Mar;35(3):343–51. PMID 3883235
  41. ^ Robertson MM. Tourette syndrome, associated conditions and the complexities of treatment. Brain. 2000;123 Pt 3:425–462. doi:10.1093/brain/123.3.425 PMID 10686169
  42. ^ Pandey S, Srivanitchapoom P, Kirubakaran R, Berman BD (January 2018). "Botulinum toxin for motor and phonic tics in Tourette's syndrome". Cochrane Database Syst Rev (Review). 1: CD012285. doi:10.1002/14651858.CD012285.pub2. PMC 6491277. PMID 29304272.
  43. ^ Sukhodolsky DG, Scahill L, Zhang H, et al. Disruptive behavior in children with Tourette's syndrome: association with ADHD comorbidity, tic severity, and functional impairment. J Am Acad Child Adolesc Psychiatry. 2003 Jan;42(1):98–105. PMID 12500082
    * Hoekstra PJ, Steenhuis MP, Troost PW, et al. Relative contribution of attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and tic severity to social and behavioral problems in tic disorders. J Dev Behav Pediatr. 2004 Aug;25(4):272–9. PMID 15308928
    * Carter AS, O'Donnell DA, Schultz RT, et al. Social and emotional adjustment in children affected with Gilles de la Tourette's syndrome: associations with ADHD and family functioning. Attention Deficit Hyperactivity Disorder. J Child Psychol Psychiatry. 2000 Feb;41(2):215–23. PMID 10750547
    * Spencer T, Biederman J, Harding M, et al. Disentangling the overlap between Tourette's disorder and ADHD. J Child Psychol Psychiatry. 1998 Oct;39(7):1037–44. doi:10.1111/1469-7610.00406 PMID 9804036
  44. ^ a b Freeman, RD. Tourette's Syndrome: minimizing confusion. Retrieved on February 8, 2006. Roger Freeman, MD, is the clinical head of the Neuropsychiatry Clinic, British Columbia's Children's Hospital, professional advisory board member of the Tourette Syndrome Foundation of Canada, and former member of the Tourette Syndrome Association Medical Advisory Board. Dr. Freeman has over 180 journal-published articles on PubMed.
  45. ^ Palumbo D, Spencer T, Lynch J, et al. Emergence of tics in children with ADHD: impact of once-daily OROS methylphenidate therapy. J Child Adolesc Psychopharmacol. 2004 Summer;14(2):185–94. PMID 15319016
    * Kurlan R. Tourette's syndrome: are stimulants safe? Curr Neurol Neurosci Rep. 2003 Jul;3(4):285–8. PMID 12930697
    * Law SF, Schachar RJ. Do typical clinical doses of methylphenidate cause tics in children treated for attention-deficit hyperactivity disorder? J Am Acad Child Adolesc Psychiatry. 1999 Aug;38(8):944–51. PMID 10434485
    * Nolan EE, Gadow KD, Sprafkin J. Stimulant medication withdrawal during long-term therapy in children with comorbid attention-deficit hyperactivity disorder and chronic multiple tic disorder. Pediatrics. 1999 Apr;103 (4 Pt 1):730–7. doi:10.1542/peds.103.4.730 PMID 10103294
  46. ^ Tourette's Syndrome Study Group. Treatment of ADHD in children with tics: a randomized controlled trial. Neurology. 2002 Feb 26;58(4):527–36. PMID 11865128
  47. ^ Spencer T, Biederman J, Steingard R, Wilens T. Bupropion exacerbates tics in children with attention-deficit hyperactivity disorder and Tourette's syndrome. J Am Acad Child Adolesc Psychiatry. 1993 Jan;32(1):211–4. doi:10.1097/00004583-199301000-00030 PMID 8428875
  48. ^ Poncin Y, Sukhodolsky DG, McGuire J, Scahill L. Drug and non-drug treatments of children with ADHD and tic disorders. Eur Child Adolesc Psychiatry. 2007 Jul 31;16 Suppl 9:78–88. doi:10.1007/s00787-007-1010-8
  49. ^ Allen AJ, Kurlan RM, Gilbert DL, et al. Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology. 2005 Dec 27;65(12):1941–9. doi:10.1212/01.wnl.0000188869.58300.a7 PMID 16380617
  50. ^ a b c Ludlow AK, Rogers SL. "Understanding the impact of diet and nutrition on symptoms of Tourette syndrome: A scoping review". J Child Health Care. 2018 Mar;22(1):68–83. doi:10.1177/1367493517748373 PMID 29268618
  51. ^ Zinner SH. "Tourette syndrome—much more than tics". Contemporary Pediatrics. Aug 2004;21(8):22–49. Part 1 PDF Part 2 PDF
  52. ^ a b Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. "Tourette syndrome and tic disorders: a decade of progress". J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):947–68. doi:10.1097/chi.0b013e318068fbcc PMID 17667475
  53. ^ Robertson MM. "Gilles de la Tourette syndrome: the complexities of phenotype and treatment". Br J Hosp Med (Lond). 2011 Feb;72(2):100–7. PMID 21378617
  54. ^ Du JC, Chiu TF, Lee KM, et al. "Tourette syndrome in children: an updated review". Pediatr Neonatol. 2010 Oct;51(5):255–64. doi:10.1016/S1875-9572(10)60050-2 PMID 20951354
  55. ^ Statement: Deep Brain Stimulation and Tourette Syndrome. Tourette Syndrome Association. Retrieved on February 26, 2005.
  56. ^ Malone DA Jr, Pandya MM. Behavioral neurosurgery. Adv Neurol. 2006;99:241–7. PMID 16536372
  57. ^ Viswanathan A, Jimenez-Shahed J, Baizabal Carvallo JF, Jankovic J. Deep brain stimulation for Tourette syndrome: target selection. Stereotact Funct Neurosurg. 2012;90(4):213–24. PMID 22699684 doi:10.1159/000337776
  58. ^ a b c Baldermann JC, Schüller T, Huys D, et al. (2016). "Deep brain stimulation for Tourette syndrome: a systematic review and meta-analysis". Brain Stimul (Review). 9 (2): 296–304. doi:10.1016/j.brs.2015.11.005. PMID 26827109.
  59. ^ a b c Fraint A, Pal G (2015). "Deep brain stimulation in Tourette's syndrome". Front Neurol (Review). 6: 170. doi:10.3389/fneur.2015.00170. PMC 4523794. PMID 26300844.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  60. ^ Viswanathan A, Jimenez-Shahed J, Baizabal Carvallo JF, Jankovic J (2012). "Deep brain stimulation for Tourette syndrome: target selection". Stereotact Funct Neurosurg (Review). 90 (4): 213–24. doi:10.1159/000337776. PMID 22699684. Archived from the original on 2013-10-06.

Book sources

  • Cohen DJ, Jankovic J, Goetz CG, eds (2001). Advances in Neurology, Tourette Syndrome. 85. Philadelphia, PA: Lippincott, Williams & Wilkins. ISBN 0-7817-2405-8
  • Kushner HI (2000). A Cursing Brain?: The Histories of Tourette Syndrome. Harvard University Press. ISBN 0-674-00386-1.
  • Leckman JF, Cohen DJ (1999). Tourette's Syndrome—Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. John Wiley & Sons, Inc., New York. ISBN 0-471-16037-7
  • Martino D, Leckman JF, eds (2013). Tourette syndrome. Oxford University Press. ISBN 978-0199796267.
    • Bloch MH (2013). "Clinical course and adult outcome in Tourette syndrome". In Martino D, Leckman JF, eds. Tourette syndrome. Oxford University Press. pp. 107–20.
    • Müller-Vahl KR (2013). "Information and social support for patients and families". In Martino D, Leckman JF, eds. Tourette syndrome. Oxford University Press. pp. 623–35.
    • Pruitt SK, Packer LE (2013). "Information and support for educators". In Martino D, Leckman JF, eds. Tourette syndrome. Oxford University Press. pp. 636–55.
  • Sukhodolsky DG, Gladstone TR, Kaushal SA, Piasecka JB, Leckman JF (2017). "Tics and Tourette Syndrome". In Matson JL, ed. Handbook of Childhood Psychopathology and Developmental Disabilities Treatment. Autism and Child Psychopathology Series. Springer. pp. 241–56. doi:10.1007/978-3-319-71210-9_14.

External links

Retrieved from "https://en.wikipedia.org/w/index.php?title=Management_of_Tourette_syndrome&oldid=942799522"