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Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Tourette’s syndrome is also quite common, and since it begins in childhood, this disorder will be frequently seen in the obstetric population. Tourette’s syndrome involves the combination of motor and vocal tics, which evolve and fluctuate over time. A tic is a brief un-voluntary movement or sound that can include throat clearing, coughing, sighing, or making sounds or words. The tics can be suppressed voluntarily but take a great deal of effort from the patient to do so. For this reason, they are called un-voluntary rather than involuntary. Patients with Tourette’s syndrome also frequently have attention deficit disorder and obsessive–compulsive disorder. The tics typically respond to dopamine receptor blockade, and haloperidol is a very effective treatment. As discussed previously, this medication is felt to be the safest choice for the fetus (80).
Gilles de la Tourette’s syndrome
Published in David Enoch, Basant K. Puri, Hadrian Ball, Uncommon Psychiatric Syndromes, 2020
David Enoch, Basant K. Puri, Hadrian Ball
Other tic disorders in DSM-5 include persistent (or chronic) motor or vocal tic disorder and provisional tic disorder. The diagnostic criteria are similar to those given above; for persistent (or chronic) motor or vocal tic disorder the criteria include:The presence of at least one motor tic or at least one vocal tic, but not bothTics occur many times daily or nearly daily or on and off for a period of more than one yearOnset before the age of 18 yearsSymptoms are not the result of medication, other drugs or another medical condition which can cause tics (e.g. seizures, Huntingtons’ disease or post-viral encephalitis)Not diagnosed with Tourette syndrome
Dopamine in the Immune and Hematopoietic Systems
Published in Nira Ben-Jonathan, Dopamine, 2020
Increasing evidence shows that infections and an activated immune status might be involved in the pathogenesis of TS, as signs of inflammation and immunological abnormalities have been described in this tic disorder [62]. Infections with group A streptococci, Borrelia burgdorferi or Mycoplasma pneumoniae, seem to be associated with symptoms of the disease. Studies have shown that immunologic treatment improves clinical symptoms in Tourette’s syndrome and prevents their reoccurrence. Postinfectious events by cross-reactive antibodies against M-protein, altered dopaminergic neurotransmission, and inflammatory/immunological dysregulations were considered as possible mechanisms that cause symptoms. Forty years of research and clinical practice have shown that DAR antagonists are effective agents in the treatment of TS by allowing a significant tic reduction of about 70% [63]. Their main effect appears to be mediated by the blockade of striatal D2Rs. Various typical and atypical agents are available, although there is discord among experts on which agents should be considered as first choice.
Current and emerging pharmacotherapeutic strategies for Tourette syndrome
Published in Expert Opinion on Pharmacotherapy, 2022
The present paper provides an overview of current and emerging pharmacotherapeutic strategies for TS. A comprehensive search for the literature on the pharmacotherapy of tics was conducted using MEDLINE (via PubMed), Scopus, and Web of Science databases. The gray literature was searched using Google Scholar. The search terms used were ‘Tourette syndrome’ OR ‘tic disorder’ OR ‘tics’ in conjunction with ‘pharmacotherapy’ OR ‘pharmacology’ OR ‘medication’ OR ‘drug’ OR ‘treatment.’ Published recommendations and expert opinions were also reviewed. No date limits were used. In addition to the medications listed by the guidelines, pharmacological agents supported by the best available evidence were selected for inclusion in the present review. This work complements recently published reviews [31–33] by integrating the best available evidence on the most commonly used anti-tic medications with ratings from the current guidelines and emerging pharmacological agents.
Impaired response inhibition during a stop-signal task in children with Tourette syndrome is related to ADHD symptoms: A functional magnetic resonance imaging study
Published in The World Journal of Biological Psychiatry, 2021
Thaïra J. C. Openneer, Dennis van der Meer, Jan-Bernard C. Marsman, Natalie J. Forde, Sophie E. A. Akkermans, Jilly Naaijen, Jan K. Buitelaar, Pieter J. Hoekstra, Andrea Dietrich
Tourette syndrome (TS) is characterised by the presence of multiple motor tics and a minimum of one vocal tic, lasting for at least one year and starting before the age of 18 years (American Psychiatric Association 2013). While the neurophysiological basis of TS is currently unclear, a widely held view is that tics originate from dysfunction in the cortico–striato–thalamo–cortical (CSTC) circuits (Albin and Mink 2006). Tics typically resemble ‘disinhibited’ behaviours, which suggest impairments in inhibitory control (i.e. the process of actively suppressing an ongoing or inappropriate response [Aron 2011; Mirabella 2014]). Indeed, a recent meta-analysis pointed to response inhibition impairments in TS (Morand-Beaulieu et al. 2017). However, the results of studies in inhibitory control are mixed; some studies identified impaired inhibitory performance in children and adults with TS compared with healthy controls (Goudriaan et al. 2006; Channon et al. 2009; Wylie et al. 2013; Yaniv et al. 2018), whereas other studies found no inhibitory impairment (Ray Li et al. 2006; Roessner et al. 2008; Eichele et al. 2010; Sukhodolsky et al. 2010; Mancini, Cardona, et al. 2018).
Aripiprazole for the treatment of Tourette syndrome
Published in Expert Review of Neurotherapeutics, 2021
Joanna H. Cox, Andrea E. Cavanna
Tourette syndrome (TS) is a complex neurodevelopmental disorder characterized by multiple tics, defined as sudden, repetitive, nonrhythmic movements or vocalizations. According to the current edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), TS is diagnosed based on the presence of multiple motor tics plus at least one vocal tic, lasting for over a year and with onset before the age of 18 years [1]. Both motor and vocal tics are characteristically preceded by a sensation of mounting inner tension, often described as a ‘premonitory urge’ [2,3]. Motor tics can affect different parts of the body, and commonly include uncontrollable eye blinking, facial grimacing, shoulder shrugging, or head shaking [4]. Vocal tics are the involuntary repetitive expression of sounds, such as sniffing, grunting, or humming [5]. Other less common features of TS include echophenomena (repetition of another person’s speech or gestures), paliphenomena (repetition of own words of movements) and coprophenomena (involuntary expression of obscene language or gestures) [6]. Despite stereotypical portrayals of TS in the media, complex vocal tics such as coprolalia and other socially inappropriate symptoms have been reported in a minority of patients with TS and are not included in the diagnostic criteria [7,8]. TS is listed in the ‘Tic disorders’ category of the DSM-5, alongside other tic disorders, including persistent (or chronic) motor or vocal tic disorder, and provisional tic disorder (which replaced the former category of transient tic disorder) [1].