小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 可见抽搐
- 先兆感觉
- 抑制抽搐的能力
- 注意力分散能缓解症状
- 其他神经系统检查正常
其他诊断因素
- 压力、焦虑、兴奋或变动时症状加重
- 严重程度随着时间而变
- 并发精神障碍的症状
危险因素
- 发病时 < 18 岁
- 男性
- 抽动家族史
- 强迫症 (OCD)、ADHD 或抑郁症家族史
- 孕妇产前吸烟
- OCD 或 ADHD 病史
- 孤独症谱系障碍病史
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 脑部 MRI,注射或未注射造影剂
- 脑电图检查
- 脑脊液分析(腰椎穿刺)
治疗流程
症状不会影响日常生活
影响日常生活的症状:非妊娠
行为治疗和药物治疗无效的重度抽动
症状不会影响日常生活:妊娠
撰稿人
作者
Tamara Pringsheim, MD, FRCPC
Professor
University of Calgary
Department of Clinical Neurosciences, Psychiatry, Pediatrics, and Community Health Sciences
Calgary
Canada
利益声明
TP has received research grants for Tourette's syndrome from Alberta Health and the Alberta Children's Hospital Research Institute. TP is an author of several references cited in this topic.
鸣谢
Professor Tamara Pringsheim would like to gratefully acknowledge Dr Tanya K. Murphy, Dr Fatima Masumova, Dr Cathy L. Budman, Dr Amber Stocco, Dr Migvis Monduy, and Dr Bobbi Hopkins, previous contributors to this topic.
利益声明
FM, AS, MM, and BH declare that they have no competing interests. TKM has received research grants from Auspex Pharmaceuticals, the National Institute of Mental Health, Shire Pharmaceuticals, Pfizer Inc., F. Hoffman-La Roche Ltd., AstraZeneca Pharmaceuticals, Centers for Disease Control and Prevention, Massachusetts General Hospital, Sunovion Pharmaceuticals, Neurocrine Bioscience, Psyadon Pharmaceuticals, and PANDAS Network; she is on the advisory board for the International Obsessive Compulsive Foundation; she is also an author of several references cited in this topic. CLB has received research funding from Otsuka, Psyadon, Auspex, Teva, Neurocrine, and Synchroneuron Pharmaceuticals; she is a consultant for Bracket and a paid speaker for the Centers for Disease Control and Prevention (CDC) - National Tourette Syndrome Association Partnership; she is an author of several references cited in this topic.
同行评议者
Francis Filloux, MD
Chief
Division of Pediatric Neurology
University of Utah School of Medicine
Salt Lake City
UT
利益声明
FF declares that he has no competing interests.
鉴别诊断
- 功能性抽动样行为
- 强迫症(OCD)
- 刻板行为
更多 鉴别诊断指南
- 抽动障碍的诊断
- Tourette 氏综合征和慢性抽动障碍患者的抽动治疗
更多 指南患者教育信息
何为 ADHD?
儿童 ADHD:如何有效治疗?
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