Reportagem sobre Tourette na TV Novomundo

Não consegui ainda o vídeo para que possa ser visto direto no posto, mas clique no link que poderá vê-lo.

Meu filho tem tique de piscar os olhos: e agora?

Muitos pais trazem seus filhos para consulta quando observam tiques de piscar os olhos em seus filhos. A maioria vai primeiro ao oculista, ao alergologista, ao neurologista e por fim ao psiquiatra. O artigo abaixo relata um estudo que foi feito com crianças de 8 anos em acompanhamento por alguns anos (média de 6 anos) e que de início apresentavam tiques de olhos: piscar, rodar e abrir os olhos forçadamente e não tinham um diagnóstico de Tourette ou TOC. Das 32 crianças que foram reavaliadas, 10, ou seja, 1/3, preenchia critérios para ST. Ou seja, embora este seja um estudo pequeno, mostra que há 33% de chance de que tiques nos olhos possam ser o início de um quadro de Tourette.         

J AAPOS. 2014 Feb;18(1):31-5. doi: 10.1016/j.jaapos.2013.11.007.

The long-term outcomes of ocular tics in a pediatric neuro-ophthalmology practice.

Bisker ER1, McClelland CM2, Brown LW3, Liu GT4.

Abstract

PURPOSE:

To describe the outcome and comorbidities of ocular tics in children evaluated by a pediatric neuro-ophthalmologist.

METHODS:

The medical records of all consecutive patients in a pediatric neuro-ophthalmology practice diagnosed with ocular tics (eye rolling, blinking, and widening) were retrospectively reviewed. Children with known secondary causes for tics were excluded. Patients, parents, and/or guardians were contacted by telephone to obtain follow-up information.

RESULTS:

A total of 43 patients were included in the retrospective cohort, with a mean age of 7.8 ± 4.8 years at diagnosis. Thirty-two patients participated in the follow-up survey, with an average follow-up of 6.1 ± 3.9 years. None of the 43 children carried a diagnosis of Tourette syndrome or obsessive-compulsive disorder (OCD) at presentation; 1 child had attention deficit hyperactivity disorder (ADHD). At follow-up, 14 of the 32 children (44%) had persistent ocular tics, 3 (9%) reported new nonocular motor tics, 5 (16%) reported new vocal tics, and 4 (13%) developed both nonocular motor and vocal tics. One patient (3%) was formally diagnosed with Tourette syndrome during the follow-up interval, and 3 (9%) were diagnosed with ADHD.

CONCLUSIONS:

Almost half of the children with ocular tics at presentation had persistent ocular tics on follow-up. New nonocular motor and vocal tics occurred in several patients.

Coprolalia e copropraxia em Tourette

Neurol Neurochir Pol. 2014;48(1):1-7. doi: 10.1016/j.pjnns.2013.03.001. Epub 2014 Jan 23.

Coprolalia and copropraxia in patients with Gilles de la Tourette syndrome.

Kobierska M1, Sitek M1, Gocyła K2, Janik P3.

Author information

Abstract

BACKGROUND AND PURPOSE:

Involuntary expression of socially unacceptable words (coprolalia) or gestures (copropraxia) is the best-known symptom of Gilles de Tourette syndrome (GTS) that contributes to the social impairment. The aim of the study was to assess the prevalence, age at onset and co-occurring symptoms of coprophenomena.

MATERIALS AND METHODS:

One hundred and sixty-eight consecutive subjects with GTS including 94 adults and 74 children and aged between 4 and 54 years (mean: 18.0±8.3) were studied. Demographic and clinical data were obtained from medical history and neurological examination.

RESULTS:

Coprolalia or copropraxia appeared in 44 patients. Both coprophenomena were present in 9 patients. Coprolalia occurred in 25.0% (n=42) and copropraxia in 6.5% (n=11) of patients. Mean age at onset was 12.2±5.7 years (range: 4-33) for coprolalia and 12.4±4.9 years (range: 7-24) for copropraxia. Coprolalia started 4.4±3.7 years (range: 0-16) after the onset of disease; copropraxia started 6.1±4.0 years (range: 1-12) after the onset of the disease. Coprolalia began in adulthood in six patients only, and copropraxia in one person. In six patients, coprolalia appeared in the first year of the disease. Copropraxia was never seen in the first year of the disease. Coprophenomena were more frequent in patients with comorbid mental disorders, behavioral problems and severe tics. Three quarters of patients reported significant influence of coprophenomena on daily living.

CONCLUSIONS:

Coprophenomena affect one quarter of GTS patients, appear in the time when tics are most severe, and are positively associated with comorbidity and more severe form of disease. Coprophenomena may reflect more widespread dysfunction of brain in GTS.

Copyright © 2014 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Vídeo curto sobre uma menininha com Tourette- Flying Anne

http://aeon.co/film/flying-anne-a-short-film-about-tourettes-syndrome/

Tourette e Alergias

Na prática clínica eu já tinha percebido que as crianças com Tourette tinha e grande frequência doenças alérgicas tais como rinite, bronquite, asma etc. Alguns pacientes meus desenvolveram Púrpura Trombocitopênica que é uma reação a medicamento com baixa das plaquetas e que parece ter origem autoimune.
Dada a frequência da associação entre rinite alérgica e os tiques de nariz (mexer o nariz, fungar etc), atualmente é prática corrente eu tratar a rinite dos pacientes além de tratar os tiques, sendo o resultado muito melhor.
Pois bem, começaram a aparecer estudos que comprovam a associação entre doenças alérgicas e a Tourette:

Eur Rev Med Pharmacol Sci. 2014 Feb;18(3):303-10.

Association of Tourette syndrome and obsessive-compulsive disorder with allergic diseases in children and adolescents: a preliminary study.

Yuce M1, Guner SN, Karabekiroglu K, Baykal S, Kilic M, Sancak R, Karabekiroglu A.

Author information

Abstract

OBJECTIVES:

To investigate the rate of allergic diseases including asthma, allergic rhinitis and eczema in children and adolescents diagnosed with obsessive-compulsive disorder (OCD) (n:26) and/or Tourette syndrome (TS) (n:32) [OCD plus TS, n:13] compared to control subjects (n:35) [total, n:80].

PATIENTS AND METHODS:

The symptoms of any allergic disease were assessed using the ISAAC questionnaire form. Allergy diagnoses were made by a pediatric allergy specialist. Skin prick tests were applied, and IgE levels and eosinophil counts were measured.

RESULTS:

While only one-fifth of the control subjects had allergic diseases, more than half of the children with TS and/or OCD had comorbid allergic diseases. Positive skin prick tests were greater in OCD patients compared to control subjects. There were no significant differences between the groups in terms of eosinophil counts or IgE levels. Among the allergic diseases, while allergic rhinitis was diagnosed at significantly higher rates in TS patients, eczema was significantly higher in OCD patients compared to control subjects.

CONCLUSIONS:

This preliminary study shows an association between allergic diseases and TS and/or OCD. The results revealing differences in associations between types of allergic disease (rhinitis or eczema) and neuropsychiatric disorder (tic disorder or OCD) need to be investigated in further studies with higher numbers of participants, and immune markers should be examined.

PMID:

 

24563428

 

[PubMed - in process] 

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Luz no Fim do Túnel antes da cirurgia para Tourette?

Existe um dentista americano, chamado Brendan Stack,  que trata transtornos do movimento, incluindo tiques, com um aparelho dental que modifica a posição da articulação têmporo-mandibular e, pelo fato de mudar a pressão sobre o quinto nervo craniano , reduziria o estímulo ao sistema nervoso central, diminuindo os tiques.

Ele tem uma página na internet, onde mostra vídeos de pacientes com várias patologias, inclusive casos com Tourette, que melhoram muito com o tratamento.
vejam os links aqui:

http://www.tmjstack.com/videos.html

https://www.youtube.com/watch?v=WyBbVutYsqg

Fiquei muito intrigada com esses resultados incríveis e entrei em contato com um dentista que trata apneia do sono com aparelhos orais e estamos trabalhando para testar esse tratamento em casos graves que não têm melhorado com medicação.


Quando tiver alguma boa novidade postarei aqui.