Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- male sex and early childhood onset
- positive past psychiatric history
- positive family history
- abnormal movements
- vocal sounds
- premonitory sensation or urge
- otherwise normal neurological exam
Outros fatores diagnósticos
- improvement of symptoms when focused on other tasks
- worsening of symptoms under stress
- ritualistic behaviors
Fatores de risco
- male sex
- age 3 to 8 years
- family history of TS or tics
- history of OCD or ADHD
- family history of OCD or ADHD
- maternal prenatal smoking
- first trimester maternal stress and severe nausea/vomiting
- low birth weight
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical diagnosis
Investigações a serem consideradas
- brain MRI
- EEG
- premonitory urge for tics scale (PUTS)
Algoritmo de tratamento
without ADHD or OCD
with ADHD
with OCD
Colaboradores
Autores
Marco A. Grados, MD, MPH
Clinical Director
Associate Professor of Psychiatry and Behavioral Sciences
Department of Psychiatry and Behavioral Sciences
Division for Child and Adolescent Psychiatry
Johns Hopkins Medicine
Baltimore
MD
Declarações
MAG declares that he has no competing interests.
Agradecimentos
Dr Marco Grados would like to gratefully acknowledge Dr Blanca Garcia-Delgar, Dr Barbara J. Coffey, Dr Victoria Chang and Dr Steven Frucht, the previous contributors to this topic.
Revisores
Anna Basu, BM, BCh, PhD, MA, MRCPCH
Specialised Registrar
Paediatric Neurology
Honorary Clinical Lecturer
Newcastle General Hospital
Newcastle-upon-Tyne
UK
Declarações
AB declares that she has no competing interests.
Jonathan Mink, MD, PhD
Professor of Neurology, Neurobiology, Anatomy and Pediatrics
Chief Child Neurology
University of Rochester
Rochester
NY
Declarações
JM is an author of a number of references cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Keen-Kim D, Freimer NB. Genetics and epidemiology of Tourette syndrome. J Child Neurol. 2006;21:665-671. Resumo
Mink JW. Neurobiology of basal ganglia and Tourette syndrome: basal ganglia circuits and thalamocortical outputs. Adv Neurol. 2006;99:89-98. Resumo
Cath DC, Hedderly T, Ludolph AG, et al; European Society for the Study of Tourette Syndrome (ESSTS) Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part I: assessment. Eur Child Adolesc Psychiatry. 2011;20:155-171.Texto completo Resumo
Whittington C, Pennant M, Kendall T, et al. Practitioner review: treatments for Tourette syndrome in children and young people - a systematic review. J Child Psychol Psychiatry. 2016 May 2 [Epub ahead of print]. Resumo
Verdellen C, van de Griendt J, Hartmann A, et al; European Society for the Study of Tourette Syndrome (ESSTS) Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part III: behavioural and psychosocial interventions. Eur Child Adolesc Psychiatry. 2011;20:197-207.Texto completo Resumo
Dutta N, Cavanna AE. The effectiveness of habit reversal therapy in the treatment of Tourette syndrome and other chronic tic disorders: a systematic review. Funct Neurol. 2013;28:7-12.Texto completo Resumo
Roessner V, Plessen KJ, Rothenberger A, et al; European Society for the Study of Tourette Syndrome (ESSTS) Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment. Eur Child Adolesc Psychiatry. 2011;20:173-196.Texto completo Resumo
Jimenez-Jimenez FJ, Garcia-Ruiz PJ. Pharmacological options for the treatment of Tourette's disorder. Drugs. 2001;61:2207-2220. Resumo
Rizzo R, Gulisano M, Calì PV, et al. Tourette syndrome and comorbid ADHD: current pharmacological treatment options. Eur J Paediatr Neurol. 2013;17:421-428. Resumo
Müller-Vahl KR, Cath DC, Cavanna AE, et al; European Society for the Study of Tourette Syndrome (ESSTS) Guidelines Group. European clinical guidelines for Tourette syndrome and other tic disorders. Part IV: deep brain stimulation. Eur Child Adolesc Psychiatry. 2011;20:209-217.Texto completo Resumo
Nangunoori R, Tomycz ND, Quigley M, et al. Deep brain stimulation for psychiatric diseases: a pooled analysis of published studies employing disease-specific standardized outcome scales. Stereotact Funct Neurosurg. 2013;91:345-354.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Provisional tic disorder
- Persistent (chronic) motor or vocal tic disorder
- Stereotypies
Mais Diagnósticos diferenciaisDiretrizes
- Practice guideline recommendations summary: the treatment of tics in people with Tourette syndrome and chronic tic disorders
- Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy
Mais DiretrizesFolhetos informativos para os pacientes
Obsessive-compulsive disorder
ADHD: what is it?
Mais Folhetos informativos para os pacientes
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