china tourette syndrome

About the tourette syndrome

               WHAT IS TOURETTE SYNDROME?

Tourette syndrome is a neuropsychiatric disorder with onset in childhood characterized by multiple motor tics and at least one vocal phonic tics

These tics characteristically wax and wane, can be suppressed temporarily, and are typically preceded by an unwanted

urge or sensation in the affected muscles. Some common tics are eye blinking, coughing, throat clearing, sniffing, and

facial movements. Tourette's does not adversely affect intelligence or life expectancY.

                              DEFINITION
                                                  
Tourette's is defined as part of a spectrum of tic disorders, which includes provisional, transient and persistent (chronic)

tics. While the exact cause is unknown, it is believed to involve a combination of genetic and environmental factors. There

are no specific tests for diagnosing Tourette's; it is not always correctly identified because most cases are mild and the

severity of tics decreases for most children as they pass through adolescence. Extreme Tourette's in adulthood, though

sensationalized in the media, is a rarity; tics are often unnoticed by casual observers.

In most cases, medication for tics is not necessary. Education is an important part of any treatment plan, and explanation

and reassurance alone are often sufficient treatment.Many individuals with Tourette's go undiagnosed or never seek

medical care.Among those who are seen in specialty clinics, attention-deficit hyperactivity disorder (ADHD) and obsessive–

compulsive disorder (OCD) are present at higher rates. These co-occurring diagnoses often cause more impairment to the

individual than the tics; hence, it is important to correctly identify associated conditions and treat them.

About 1% of school-age children and adolescents have Tourette syndrome.It was once considered a rare and bizarre syndrome, most

often associated with coprolalia (the utterance of obscene words or socially inappropriate and derogatory remarks), but this

symptom is present in only a small minority of people with Tourette's.The condition was named by Jean-Martin Charcot

(1825–1893) on behalf of his resident, Georges Albert édouard Brutus Gilles de la Tourette (1857–1904), a French physician

and neurologist, who published an account of nine patients with Tourette's in 1885.Some common tics are eye blinking,

coughing, throat clearing, sniffing, and facial movements.Tourette syndrome does not adversely affect intelligence or life

expectancy.

The cause of Tourette syndrome is unknown. It is more common in boys than girls. The tics usually start in childhood and may

be worst in the early teens. Many people eventually outgrow them Characteristics of Tourette syndrome.

Tourette is what?you will ask me.so i will tell you that is is a common neuropsychiatric disorder with onset in

childhood,characterized by multiple motor tics and at least one vocal phonic tic.

These tics characteristically wax and wane, can be suppressed temporarily, and are typically preceded by an unwanted urge or

sensation in the affected muscles. Some common tics are eye blinking, coughing, throat clearing, sniffing, and facial

movements. Tourette's does not adversely affect intelligence or life expectancy.

The cause of Tourette syndrome is unknown. It is more common in boys than girls. The tics usually start in childhood and may

be worst in the early teens. Many people eventually outgrow them.

change in number, frequency, severity and anatomical location. Waxing and waning the ongoing increase and decrease in

severity and frequency of tics occurs differently in each individual.Tics also occur in bouts of bouts which vary for each

person.Coprolalia is the most publicized symptom of Tourette's，but it is not required for a diagnosis of Tourette's and

only about 10% of Tourette syndrome patients exhibit it.[2] Echolalia (repeating the words of others) and palilalia (repeating

one's own words) occur in a minority of cases,[6] while the most common initial motor and vocal tics are, respectively, eye
blinking and throat clearing.

                    TOURETTE SYNDROME SYMPTOMES
                                           
Transient tic disorders consisted of multiple motor tics,phonic tics or both,with a duration between four weeks and twelve

 months. Chronic tic disorder was either single or multiple, motor or phonic tics of tourette syndrome which were present for

 more than a year.[6] Tourette's is diagnosed when multiple motor tics, and at least one phonic tic, are present for more than a

 year.The fifth versionpublished in May 2013, reclassified Tourette's and tic disorders as motor disorders listed in the

 Neurodevelopmental disorder category, and replaced transient tic disorder with provisional tic disorder, but made few other

  the most publicized symptom of Tourette's, but it is not required for a diagnosis of Tourette's and only about 10% of
 
  Tourette's patients exhibit it.Echolalia repeating the words of others and palilalia repeating one's own words occur in a
 
  minority of cases,while the most common initial motor and vocal tics are, respectively, eye blinking and throat clearing.

In contrast to the abnormal movements of other movement disorders (for example, choreas, dystonias, myoclonus, and dyskinesias)

the tics of Tourette's are temporarily suppressible, nonrhythmic, and often preceded by an unwanted premonitory urge.

 Immediately preceding tic onset, most individuals with Tourette's are aware of an urge,similar to the need to sneeze or scratch

 an itch. Individuals describe the need to tic as a buildup of tension, pressure, or energy[18][19] which they consciously

 choose to release, as if they "had to do it"[20] to relieve the sensation[18] or until it feels "just right".[20][21] Examples

 of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders,

 leading to the need to clear one's throat or shrug the shoulders. The actual tic may be felt as relieving this tension or

 sensation, similar to scratching an itch. Another example is blinking to relieve an uncomfortable sensation in the eye. These

 urges and sensations, preceding the expression of the movement or vocalization as a tic, are referred to as "premonitory

 sensory phenomena" or premonitory urges. Because of the urges that precede them, tics are described as semi-voluntary or

 "unvoluntary",rather than specifically involuntary; they may be experienced as a voluntary, suppressible response to the

 unwanted premonitory urge.[2] Published descriptions of the tics of Tourette's identify sensory phenomena as the core symptom

 of the syndrome, even though they are not included in the diagnostic criteria.

 significant changes  Tourette syndrome in older individuals are mild and almost unrecognizable.When symptoms are severe enough

 to warrant referral to clinics
                     CAUSES OF TOURETTE SYNDROME
                                              
 The exact cause of Tourette syndrome is unknown,but it is well established that both genetic and environmental factors are

 involved.Genetic epidemiology studies have shown that the overwhelming majority of cases of Tourette syndrome are inherited,

 although the exact mode of inheritance is not yet known and no gene has been identified.In other cases, tics are associated

 with disorders other than Tourette,a phenomenon known as tourettism.

A person with Tourette syndrome has about a 50% chance of passing the gene to one of his or her children, but Tourette syndrome

 is a condition of variable expression and incomplete penetrance.Thus, not everyone who inherits the genetic vulnerability will

 show symptoms even close family members may show different severities of symptoms of tourette or no symptoms at all. The gene

 may express as Tourette,as a milder tic disorder provisional or chronic tics, or as obsessive–compulsive symptoms without tics.

 Only a minority of the children who inherit the gene have symptoms severe enough to require medical attention.Gender appears to

 have a role in the expression of the genetic vulnerability males are more likely than females to express tics.

Non-genetic, environmental, post-infectious, or psychosocial factors—while not causing Tourette syndrome can influence its

severity.Autoimmune processes may affect tic onset and exacerbation in some cases. In 1998,a team at the US National Institute

of Mental Health proposed a hypothesis based on observation of 50 children that both obsessive–compulsive disorder(OCD) and tic

disorders may arise in a subset of children as a result of a poststreptococcal autoimmune process.[5] Children who meet five

diagnostic criteria are classified,according to the hypothesis,as having Pediatric Autoimmune Neuropsychiatric Disorders

Associated with Streptococcal infections.This contentious hypothesis is the focus of clinical and laboratory

research, but remains unproven.Some forms of OCD may be genetically linked to Tourette's.A subset of OCD is thought to be

etiologically related to Tourette's and may be a different expression of the same factors that are important for the expression

of tics.The genetic relationship of ADHD to Tourette syndrome, however, has not been fully established.

                    TOURETTE SYNDROME DISORDERS
                                          
According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Tourette Syndrome may be

diagnosed when a person exhibits both multiple motor and one or more vocal tics over the period of a year the motor and vocal

tics need not be concurrent. The onset must have occurred before the age of 18, and cannot be attributed to the effects of

another condition or substance such as cocaine.Hence, other medical conditions that include tics or tic-like movements—such as

autism or other causes of tourette syndrome must be ruled out before conferring a Tourette diagnosis. Since 2000, the DSM has

recognized that clinicians see patients who meet all the other criteria but do not have distress or impairmentfor tourette.

There are no specific medical or screening tests that can be used in diagnosing Tourette syndrome it is frequently misdiagnosed

or underdiagnosed, partly because of the wide expression of severity,ranging from mild the majority of cases or moderate,to

severe the rare, but more widely recognized and publicized cases.Coughing, eye blinking, and tics that mimic unrelated

conditions such as asthma are commonly misdiagnosed.The diagnosis is made based on observation of the individual's symptoms and

family history,and after ruling out secondary causes of tic disorders.In patients with a typical onset and a family history of

tics or obsessive–compulsive disorder, a basic physical and neurological examination may be sufficient.

There is no requirement that other comorbid conditions such as ADHD or OCD be present,but if a physician believes that there may

be another condition present that could explain tics, tests may be ordered as necessary to rule out that condition. An example

of this is when diagnostic confusion between tics and seizure activity exists,which would call for an EEG, or if there are

symptoms that indicate an MRI to rule out brain abnormalities.TSH levels can be measured to rule out hypothyroidism, which can

be a cause of tics. Brain imaging studies are not usually warranted.In teenagers and adults presenting with a sudden onset of

tourette symptome tics and other behavioral symptoms,a urine drug screen for cocaine and stimulants might be necessary.If a

family history of liver disease is present, serum copper and ceruloplasmin levels can rule out Wilson's disease.Most cases are

diagnosed by merely observing a history of tics.Secondary causes of tourette syndrome tics not related to inherited Tourette

syndrome are commonly referred to as tourettism.Dystonias choreas,other genetic conditions, and secondary causes of tics should

be ruled out in the differential diagnosis for Tourette syndrome.Other conditions that may manifest tics or stereotyped

movements include developmental disorders, autism spectrum disorders,and stereotypic movement disorder;Sydenham's chorea

idiopathic dystonia and genetic conditions such as Huntington's disease, neuroacanthocytosis, Hallervorden-Spatz syndrome,

Duchenne muscular dystrophy, Wilson's disease, and tuberous sclerosis. Other possibilities include chromosomal disorders such as

Down syndrome, Klinefelter syndrome, XYY syndrome and fragile X syndrome. Acquired causes of tics include drug-induced tics,

head trauma, encephalitis,stroke,and carbon monoxide poisoning.The symptoms of Lesch-Nyhan syndrome may also be confused with

Tourette syndrome.Most of these conditions are rarer than tic disorders,and a thorough history and examination may be enough to

rule them out, without medical or screening tests.

Although not all people with Tourette syndrome have comorbid conditions,most Tourette's patients presenting for clinical care

at specialty referral centers may exhibit symptoms of other conditions along with their motor and phonic tics.Associated

conditions include attention-deficit hyperactivity disorder (ADD or ADHD), obsessive–compulsive disorder (OCD),learning

disabilities and sleep disorders.Disruptive behaviors, impaired functioning,or cognitive impairment in patients with comorbid

Tourette syndrome and ADHD may be accounted for by the comorbid ADHD, highlighting the importance of identifying and treating

comorbid conditions.Disruption from tics is commonly overshadowed by comorbid conditions that present greater interference to

the child.Tic disorders in the absence of ADHD do not appear to be associated with disruptive behavior or functional

impairment,while impairment in school, family,or peer relations is greater in patients who have more comorbid conditions and

determines whether therapy is needed.mild,to the extent that casual observers might not know of their condition.The overall

prognosis is positive, but a minority of children with Tourette syndrome have severe symptoms that persist into adulthood.A

study of 46 subjects at 19 years of age found that the symptoms of 80% had minimum to mild impact on their overall functioning,

and that the other 20% experienced at least a moderate impact on their overall functioning.[6] The rare minority of severe cases

can inhibit or prevent individuals from holding a job or having a fulfilling social life. In a follow-up study of thirty-one

adults with Tourette's, all patients completed high school, 52% finished at least two years of college, and 71% were full-time

employed or were pursuing higher education.                   
                                           
                     CHINESE TRADITIONAL SOLUTION
                                             
The history of Luoyang Wang Shixiong Juyuantang was almost two hundred years. It was welcome for skilled medical technology,

specialized medical team and excellent medical service. Wang Shixiong Juyuantang has leadership position in Tourette syndrome

treatment. The secret prescription to cure the tourette syndrome handed down from ancestor was magic secret prescription, which

created a true legend. More than ten thousands patients of the tourette syndrome were cured well by using the secret

prescription. The seventh successor Wang Wenli specialist inherited admirable medical tradition, devoted herself to treatment of

Tourette syndrome all the time, and accumulated rich clinical experience, helped more than ten thousands patients to get

healthy. Her contribution to Tourette syndrome has owned her consistent praise from the associated experts and

patients.Tourette Syndrome(TS) Institute of Wang Shixiong Juanyuantang(WSJ)focuses on TS treatment with TCM, therefore study of

Chinese herbal preparation process is one of the most important research subjects.Chinese herbs processing laboratory was

founded in order to study processing of Chinese herbs.Chinese herbs laboratory of Tourette Syndrome Institution of Wang Shixiong

Juyuantang processed the Chinese herbs by classification based on clinical application purpose with its own characteristics.

Therefore Chinese herbs processed were safe, effective, stable and low toxicity to cure the torette syndrome .After scraping

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