Singer Harvey S
Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore 21287, USA.
Handb Clin Neurol. 2011;100:641-57. doi: 10.1016/B978-0-444-52014-2.00046-X.
Tic disorders, including Tourette syndrome, are an intriguing group of paroxysmal movement abnormalities that begin in childhood, have a fluctuating course, are capable of causing psychosocial and physical problems, and often improve by early adulthood. These disorders are frequently associated with a variety of comorbid problems whose negative effects may exceed those of tics. Therapy is strictly symptomatic and usually includes educational, behavioral, and a variety of pharmacological therapies. Although there is strong evidence supporting an inherited basis, the precise genetic abnormality remains unknown. A proposed poststreptococcal autoimmune etiology remains controversial. Pathophysiologically, tics appear to arise from an alteration within cortico-striatal-thalamo-cortical circuits, but the definitive site is unknown. Evidence supports an abnormality of synaptic neurotransmission, likely involving the dopaminergic system.
抽动障碍，包括图雷特综合征，是一组有趣的阵发性运动异常，始于儿童期，病程波动，可导致心理社会和身体问题，且常在成年早期有所改善。这些障碍常与多种共病问题相关，其负面影响可能超过抽动本身。治疗严格对症，通常包括教育、行为和多种药物治疗。尽管有强有力的证据支持其遗传基础，但确切的基因异常仍不清楚。一种提出的链球菌感染后自身免疫病因仍存在争议。在病理生理学上，抽动似乎源于皮质-纹状体-丘脑-皮质回路的改变，但确切部位尚不清楚。有证据支持突触神经传递异常，可能涉及多巴胺能系统。
