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Tourette's syndrome

  • მიმოხილვა
  • თეორია
  • დიაგნოზი
  • მართვა
  • მეთვალყურეობა
  • წყაროები
ბოლო მიმოხილვა: 11 Jul 2025
ბოლო განახლება: 17 Jan 2023

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presence of risk factors
  • early childhood onset
  • abnormal movements
  • vocal sounds
  • premonitory sensation or "urge"
  • otherwise normal neurological examination
Todos los datos

Otros factores de diagnóstico

  • improvement of symptoms when focused on other tasks
  • worsening of symptoms under stress
  • ritualistic behaviours
Todos los datos

Factores de riesgo

  • 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 antenatal smoking
  • first trimester maternal stress and severe nausea/vomiting
  • low birth weight
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • clinical diagnosis
Todos los datos

Pruebas diagnósticas que deben considerarse

  • brain MRI
  • EEG
  • premonitory urge for tics scale (PUTS)
Todos los datos

Algoritmo de tratamiento

En curso

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

Divulgaciones

MAG declares that he has no competing interests.

Agradecimientos

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 por pares

Anna Basu, BM, BCh, PhD, MA, MRCPCH

Specialised Registrar

Paediatric Neurology

Honorary Clinical Lecturer

Newcastle General Hospital

Newcastle-upon-Tyne

UK

Divulgaciones

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

Divulgaciones

JM is an author of a number of references cited in this topic.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Keen-Kim D, Freimer NB. Genetics and epidemiology of Tourette syndrome. J Child Neurol. 2006;21:665-671. Resumen

Mink JW. Neurobiology of basal ganglia and Tourette syndrome: basal ganglia circuits and thalamocortical outputs. Adv Neurol. 2006;99:89-98. Resumen

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]. Resumen

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  Resumen

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  Resumen

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  Resumen

Jimenez-Jimenez FJ, Garcia-Ruiz PJ. Pharmacological options for the treatment of Tourette's disorder. Drugs. 2001;61:2207-2220. Resumen

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. Resumen

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  Resumen

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  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

  • Diferenciales

    • Provisional tic disorder
    • Persistent (chronic) motor or vocal tic disorder
    • Stereotypies
    Más Diferenciales

  • Guías de práctica clínica

    • Practice guideline recommendations summary: the treatment of tics in people with Tourette syndrome and chronic tic disorders
    • Attention deficit hyperactivity disorder: diagnosis and management
    Más Guías de práctica clínica

  • Folletos para el paciente

    Tourette’s syndrome

    ADHD: what is it?

    Más Folletos para el paciente
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