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
therapy, you should avoid wind, cold shower as well as cold drink to ensure your body’s boosted metabolism and self-healing
process working well. Scraping Therapy plays a very important role in treating chronic pain and some hard-to-cure ailments when
it is combined with other TCM therapies like massage cupping, acupuncture etc. It is welcome because of amazing instant-lasting
results in China.
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