89例抽动秽语综合征临床分析

目的：探讨抽动秽语综合征（Tourette综合征,TS）的临床特点、病因及治疗。方法：结合文献回顾性分析89例患者的临床资料。结果：87．6％的TS患者出现简单发声,85％的抽动首发症状在颜面部。部分TS的 发病与巨细胞病毒（cytomegalovirus,CMV)感染有关。结论：利培酮有望成为治疗TS的良好药物。     

抽动秽语综合征免疫病因学研究进展

本文综述了抽动秽语综合征及相关障碍在免疫学方面的研究进展。     

抽动秽语综合征免疫病因学研究进展

本文综述了抽动秽语综合征及相关障碍在免疫学方面的研究进展。     

泰必利联合肌苷治疗抽动-秽语综合征

目的 探讨肌苷是否具有治疗抽动-秽语综合征(Tourette综合征)的临床价值.方法 58例患者分为泰必利组和泰必利加用肌苷组两个治疗组,用药和观察时间不少于6个月.结果 泰必利加肌苷组与单纯泰必利组痊显率比较有显著差异性(P<0.05).结论 肌苷对Tourette综合征具有治疗作用,其药理机制可能与肌苷的抗多巴胺能活性作用有关.     

抽动——秽语综合征临床及预后

抽动＿秽语综合征临床及预后山东省济宁市精神病防治院（２７２１５１）刘立芬陈洪王健苏中华抽动＿秽语综合征是儿童较常见慢性神经精神障碍之一，Ｉｔａｒｄ于１８２５年首先报告。本症是以多发性运动性抽动伴有不自主发声为主要特征［１］。虽然本症少见，但它对儿童的...     

抽动秽语综合征50例临床与脑电图分析

目的：通过50例抽动秽语综合征患儿的临床与脑电图分析，探讨脑电图在临床脑功能评价中的应用，方法：采用日本光电4418型脑电图仪，对抽动秽语综合征的患儿进行检查。结果：正常32例，异常18例，异常率为36％，结论：TS患儿有部分存在脑功能障碍，脑电图对评价其引起脑功能损害及估计预后，有较重要价值。     

抽动秽语综合征的临床特征分析

目的探讨抽动秽语综合征(Tourette‘s syndrome，TS)的临床特征。方法对69例抽动秽语综合征患者的临床资料进行分析。结果TS占同期儿童神经精神疾病的0.16％。早期均为多发性抽动，73．9％出现发声抽动，42％出现模仿言语；37．7％脑电图异常；47．8％有脑外伤史、难产史、早产史、感染史和母孕期间出现重大生活事件等；7.2％患儿家族中有TS、癫癇和精神分裂症患者。结论本征可能是生物、心理与环境因素相互作用所致。预后良好。     

Clinical characteristics of Tourette syndrome

Abstract The aim of the present study was to examine the clinical characteristics of Tourette syndrome (TS) in terms of symptomatology, outcome and organic and genetic factors, and to compare these with results of previous studies on TS in Western countries and in Japan, on the basis of precise information taken from a large number of TS patients under psychiatric treatment in Japan. There was a total of 64 TS patients (55 males and nine females) selected from those who visited our outpatient clinic from 1974 to 1993 and were found to meet the criteria for Tourette's disorder of DSM-III-R. The mean patient age at entry to the present study was 17.4 years (SD:7.2). All data were collected through a systematic chart review of subjects, including data on tic symptoms and the course of their development; complications and developmental histories; family histories; medical and psychological examinations; treatment; severity and outcome. A check of the data showed that the mean age at onset was 6.9 years (SD:2.7). An analysis of the progression of the symptoms revealed that 'generalized tics' afflicting the entire body were found in 64.1% of subjects and coprolalia was found in 50%. The main complications were obsessive-compulsive symptoms (OCS) in 62.5% of patients and attention deficit hyperactivity disorder (ADHD) in 17.2%. Of their parents, 7.0% had tic disorders except TS and 1.6% had TS. Contrary to results from previous studies of TS, our study revealed that at least the incidence of coprolalia in TS patients in Japan is not lower than in Western countries. However, the frequency of familial cases seemed to be lower than previously reported for Western patients. Outcome was fairly related with 'generalized tics,' OCS, aggressiveness and ADHD.     

Spatio-temporal gait characteristics in children with Tourette syndrome: A preliminary study

Earlier studies had suggested that variability of stride length in gait is a pathological sign of basal ganglia disease. Some evidence implicates the involvement of the basal ganglia and related thalamocortical circuitry in Tourette syndrome (TS). To date, the gait of subjects with TS has only discussed in case reports. This investigation compared the spatial and temporal gait characteristics of a sample of children with TS (N = 8) with those of healthy controls (HC; N = 8). All children were instructed to walk under two speed conditions: “preferred” and “fastest.” Gait parameters were measured using an electronic walkway. Spatial and temporal gait parameters were compared using a two-way (group) × (conditions) repeated measures ANOVA. The preliminary results suggested that similar to HC children, children with TS were capable of regulating temporal characteristics of gait based on walking speed. They also exhibited subtle gait anomalies such as irregular step length, as evidenced by significant differences in step length differential (p = 0.003), detectable despite the small sample size. These findings warrant further investigation into the gait control of children with TS.     

Clinical course of Tourette syndrome

Objective

Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder characterized by multiple motor and vocal tics lasting at least a year in duration. Children with TS often experience comorbid conditions such as obsessive-compulsive disorder (OCD) and attention-deficit disorder. The goal of this article was to review the long-term clinical course of tics and comorbid conditions in children with TS.

Method

We conducted a traditional literature search to locate relevant articles regarding long-term outcome and prognosis in TS and tic disorders.

Results

Tics typically have an onset between the ages of 4 and 6 years and reach their worst-ever severity between the ages of 10 and 12 years. On average, tic severity declines during adolescence. By early adulthood, roughly three-quarters of children with TS will have greatly diminished tic symptoms and over one-third will be tic free. Comorbid conditions, such as OCD and other anxiety and depressive disorders, are more common during the adolescence and early adulthood of individuals with TS than in the general population.

Conclusion

Although tics are the sine qua non of TS, they are often not the most enduring or impairing symptoms in children with TS. Measures used to enhance self-esteem, such as encouraging strong friendships and the exploration of interests, are crucial to ensuring positive adulthood outcome in TS.     

氟哌啶醇治疗伴脑电图异常小儿多发性抽动症疗效观察

目的观察氟哌啶醇治疗伴脑电图异常小儿多发性抽动症(TS)的疗效。方法将符合《美国精神疾病诊断与统计手册》第5版诊断标准的54例小儿TS根据脑电图(EEG)结果分为EEG异常TS组和EEG正常TS组,两组患儿均给予氟哌啶醇治疗,应用《耶鲁综合抽动严重程度量表》于治疗前及治疗4周后、16周后评价其疗效。结果两组患儿在治疗前、治疗4周后、治疗16周后总运动抽动评分和总发声抽动评分总体比较,差异均有统计学意义(F=144. 60,P 0. 05; F=202. 08,P 0. 05)。两组患儿在治疗前总运动抽动评分和总发声抽动评分比较,差异均无统计学意义(P0. 05);两组患儿在治疗4周后脑电图异常TS组总运动抽动评分和总发声抽动评分比较,显著高于脑电图正常TS组(P 0. 05);两组患儿在治疗16周后总运动抽动评分和总发声抽动评分比较,差异均无统计学意义(P 0. 05)。结论氟哌啶醇治疗伴脑电图异常小儿TS有效,其近期疗效较脑电图正常小儿TS差,远期疗效与脑电图正常小儿TS无显著性差异。     

利培酮治疗难治性Tourette综合征对照观察

目的:探讨利培酮治疗难治性Tourette综合征(TS)的疗效和安全性。方法:对141例难治性TS患者,随机分为利培酮组(71例)和对照组(70例),进行8周的利培酮开放、对照研究。利培酮组以利培酮单药治疗,对照组以氟哌啶醇等单一或联合治疗。采用耶鲁抽动症状严重程度量表(YGTSS)Achenbach儿童行为量表(CBCL)、治疗中出现的症状量表(TESS),于治疗前、治疗4、8周对两组进行临床疗效及安全性评估。结果:两组症状均有改善。治疗第4周利培酮组有效率56.3%,明显高于对照组32.9%(χ2=8.212,P<0.01);利培酮组YGTSS总分(39.97±15.62)分较对照组(49.84±13.91)分显著为低(P<0.01)。治疗8周时利培酮组有效率为71.8%,明显高于对照组51.4%(χ2=6.357,P<0.05);利培酮组YGTSS总分(17.20±11.24)分明显低于对照组(24.97±10.74)分(P<0.05);减分率(76.55±14.73)%明显高于对照组(66.86±14.28)%(P<0.01)。治疗4周和8周,两组的CBCL总分均显著减少(P<0.05)。治疗4周和8周,利培酮组TESS分显著低于对照组(P<0.01)。结论:利培酮对难治性TS疗效肯定,不良反应较轻。     

Tourette syndrome and neuropsychological performance

This study examined performance on a battery of neuropsychological tests in a sample of 28 patients with Tourette's syndrome (TS). Test scores were converted to age-corrected T-scores to control for the effect of age on test performance. The frequency of abnormal test performances was variable, but more frequent on motor and sensory tasks. Symptom severity as measured by the Tourette Syndrome Global Scale was inversely related to neuropsychological performance. In general, neuropsychological performance was mildly below average. The pattern of performance was similar to previous studies of TS patients.     

A case of Tourette syndrome treated with nifedipine

A 22-year-old man with severe Tourette syndrome successfully treated with nifedipine is described. Controlled studies are called for.     

GABA 激动剂治疗儿童 Tourette 综合征的研究进展

Tourette 综合征(TS)是临床上常见的儿童精神障碍之一,主要表现为多种运动抽动和发声抽动,治疗较困难,对儿童的生活、学习、人际交往产生严重影响。临床上 TS 的治疗以药物治疗为主,常用药物包括典型和非典型抗精神病药、α2肾上腺素能受体激动剂等,但上述药物对部分患者疗效不佳,且不良反应较大。近年有研究显示 GABA 功能缺陷是 TS 发生的原因之一,现对常见的 GABA激动剂丙戊酸钠、氯硝西泮、托吡酯、左乙拉西坦、巴氯芬、卡马西平治疗儿童 TS 的研究成果进行综述,以便为儿童 TS 的治疗提供新途径。     

Tourette syndrome in children and adolescents: Special considerations

Tourette syndrome (TS) affects people of all ages, with onset in early childhood and continuing through the different stages of the life cycle into adolescence and adults. This review focuses on barriers to diagnosis and challenges in the management of young patients with TS. Barriers to identification occur at multiple levels, including detection in the community setting (including schools), parents' help-seeking behavior, and cultural influences on such behavior, as well as diagnosis by the medical provider. Challenges to management include unfamiliarity of primary care providers, inconsistencies in the diagnosis and management plan, and failure to recognize comorbid conditions, as well as inadequate knowledge and lack of resources to effectively deal with comorbidities. In addition to the complexities posed by pharmacological interactions, there are unique psychosocial challenges experienced by young people with TS and their families. Effective communication and collaboration between families, health care providers, and school personnel, as well as supportive communities, are essential components of comprehensive management.     

24小时动态脑电图监测Tourette综合征癫痫样放电

目的：探讨Ｔｏｕｒｅｔｔｅ综合征（ＴＳ）癫痫样脑波的是临床意义。方法：利用动态脑电图仪对８６例ＴＳ患儿作２４小时监测。结果：８６例ＴＳ患儿中有１３例（１５．１％）监测到ＥＥＧ癫痫样放电。其中５例（６％）合并癫痫,８例（９．３％）无癫痫发作。结论：ＴＳ的癫痫样波一部分与癫痫有关,另一部分意义未明,可能遗传有关。