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Tourette's Disorder
This is a rare disorder characterized by repetitive muscle movements and vocal outbursts. The main diagnostic criteria is as follows: At some time during the illness, though not necessarily at the same time, the patient has had both of: At least one vocal tic (A tic is a motor movement or vocalization that is nonrhythmic, rapid, repeated, stereotyped and sudden) and Multiple motor tics: For longer than 1 year, these tics have occurred many times each day, nearly every day or at intervals. During this time, the patient never goes longer than 3 months without the tics. These symptoms cause marked distress or materially impair work, social or personal functioning. The symptoms begin before age 18. Approximately 1% of mainstream schoolchildren may be affected. Onset occurs with motor tics usually followed by vocal tics. The symptoms are not directly caused by the effects of a general medical condition (such as Huntington's disease or a postviral encephalitis) or substance use (such as a CNS stimulant). Associated Features There may be other symptoms, such as mental coprolalia, obsessions, and compulsions. Other mental disorders are frequently associated are: Attention-Deficit Hyperactivity Disorder. Coprolalia. Echophenomena. Dysarthria/Involuntary Movement. Depressed Mood. Guilt/Obsession. Obsessive Compulsive Disorder. Non-obscene socially inappropriate behaviour Differential Diagnosis Some disorders have similar or even the same symptom. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis Amphetamine Intoxication. Cerebrovascular Accidents. Lesch-Nyhan Syndrome. Wilson's Disease. Huntington's Chorea Multiple Sclerosis. Organic Mental Disorders Schizophrenia. Stereotypic Movement Disorder. Pervasive Developmental Disorders. Transient Tic Disorder. Chronic Motor or Vocal Tic Disorder Cause: The cause of Tourette's Disorder is genetic in ost cases. It occurs most often in boys, and may begin around age 7 or 8. But may not appear until the child is in his or her late teens or early twenties. It may run in families. The tics are worse during emotional stress and are absent during sleep.
Transient Tic Disorder
A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. Sounds that are made involuntarily (such as throat clearing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. The patient has vocal or motor tics,or both. They can be single or multiple. For at least 4 weeks but no longer than 12 consecutive months, these tics have occurred many times each day, nearly every day. These symptoms cause marked distress or materially impair work, social or personal functioning. They began before age 18. The symptoms are not directly caused by a general medical condition (such as Huntington's disease or a postviral encephalitis) or to substance use (such as a CNS stimulant). The patient has never fulfilled criteria for Tourette's Disorder or Chronic Motor or Vocal Tic Disorder. Associated Features Dysarthria/Involuntary Movement Depressed Mood Guilt/Obsession Differential Diagnosis: Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic, attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. In Tourette's Disorder and Chronic Motor or Vocal Tic Disorder, the duration of the disturbance is at least one year Tourette's Disorder Transient Tic Disorder. Chronic Motor or Vocal Tic Disorder Cause: Transient tic disorder is common in children. Five to twenty four percent of all school age children have had tics at some stage during this period. The cause of transient tic disorder or short-lived, temporary tic, is either organic or psychogenic. The child may have facial tics or tics involving movement of the arms, legs, or other areas. Tics appear to get worse with emotional stress and are absent while sleeping.
Chronic Motor or Vocal Tic Disorder
This disorder is characterized either by rapid, recurrent, uncontrollable movements or by vocal outbursts, but not both, that have been present nearly daily for more than a year without a period free of the problem longer than three months. These repeated uncontrollable bursts of activity or speech are called tics. This Tic Disorder is diagnosed when either motor (Rapid, recurrent movement of the arms, legs, or other areas) or vocal (Vocalizations) grunts, abdominal ar diaphragmatic contractions. But not both - see Tourette's tics (sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization) are experienced persistently. Single or multiple motor or vocal tics (i.e., sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations), but not both, have been present at some time during the illness. The tics occur many times a day nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic-free period of more than 3 consecutive months. The disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning. The onset is before age 18 years. The disturbance is not due to the direct physiological effects of a substance (e.g., stimulants) or a general medical condition (e.g., Huntington's disease or postviral encephalitis). Criteria have never been met for Tourette's Disorder. Associated Features: There may be other symptoms, such as mental coprolalia -sudden, intrusive, senseless thoughts of socially unacceptable or obscene words, phrases, or sentences that differ from true obsessions in that no attempt is made to ignore, suppress, or neutralize the thoughts, obsessions, and compulsions. Differential Diagnosis: Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Obssessive-Compulsive Disorder. Attention-Deficit/Hyperactivity Disorder. Asperger's Disorder. Schizophrenia. Tics secondary to drugs (medication or abuse). Stereotypical Movement Disorder. Obsessive-Compulsive Disorder. Neurologic Medical and Drug-related Disorders Associated with Tics. Abnormal Movements (associated with medical conditions). Neurologic, primary and secondary. General Medical conditions. Drug-related tics. Cause: The incidence of chronic motor or vocal tic disorder is more common than the better known Tourette's Syndrome. The incidence of Chronic Motor or Vacal Tic disorder ranges from 1 to 2%. It is, however, rare compared to the common short-lived childhood tic (transient tic disorder). Tics appear to get worse during emotional stress and are absent during sleep. It is thought that chronic tics are a variant of Tourette's Syndrome and to have an underlying genetic cause. Prognosis for children who develop this disorder between the ages of 6 to 8 are good. Symptoms may last 4 to 6 years and then abate in early adolescence.
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