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[抽动症与图雷特综合征]

[Tics and Gilles de la Tourette syndrome].

作者信息

Tijero-Merino B, Gómez-Esteban J C, Zarranz J J

机构信息

Servicio de Neurología, Hospital de Cruces, Pl. Cruces, s/n. E-48903 Barakaldo, Vizcaya. España.

出版信息

Rev Neurol. 2009 Jan 23;48 Suppl 1:S17-20.

Abstract

INTRODUCTION

Tourette syndrome is a neurologic disorder characterized by involuntary vocal and motor tics. It affects around 1 to 2% of school-age children and is the most common movement disorder in paediatric age. Tics are involuntary or semivoluntary, sudden, brief, intermittent, repetitive movements (motor tics) or sounds (phonic tics). It is often associated with psychiatric comorbidities, mainly attention-deficit/hyperactivity disorder and obsessive-compulsive disorder. Given its diverse presentation, Tourette's syndrome can almost mimic many hyperkinetic disorders, making the diagnosis challenging at times.

DEVELOPMENT

The etiology of this syndrome is thought to be related to basal ganglia dysfunction and many clues have been pursued, both genetic and environmental factors, but no compelling major contribution to the pathogenesis of the disease has yet emerged. Treatment can be behavioural, pharmacologic, or surgical, and is dictated by the most incapacitating symptoms. Alpha-2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine-receptor-blocking drugs are required for multiple, complex tics. Dopamine-receptor-blocking drugs are associated with potential side effects.

CONCLUSION

Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected patients.

摘要

引言

抽动秽语综合征是一种神经系统疾病,其特征为不自主的发声和运动抽动。它影响着约1%至2%的学龄儿童,是儿童期最常见的运动障碍。抽动是不自主或半自主的、突然的、短暂的、间歇性的、重复性的运动(运动抽动)或声音(发声抽动)。它常与精神共病相关,主要是注意力缺陷多动障碍和强迫症。鉴于其表现多样,抽动秽语综合征有时几乎能模仿许多多动障碍,这使得诊断颇具挑战性。

发展

该综合征的病因被认为与基底神经节功能障碍有关,人们一直在探寻诸多线索,包括遗传和环境因素,但尚未出现对该疾病发病机制有说服力的主要因素。治疗方法可以是行为治疗、药物治疗或手术治疗,具体取决于最使人丧失能力的症状。α-2肾上腺素能激动剂是药物治疗的一线用药,但对于多种复杂抽动则需要多巴胺受体阻断药物。多巴胺受体阻断药物存在潜在副作用。

结论

恰当的诊断和治疗可显著改善受影响患者的生活质量和心理社会功能。

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