Gilles-de-la-Tourette-Syndrom

ZUSAMMENFASSUNG

Das Gilles-de-la-Tourette-Syndrom (GTS) zählt zu den häufigeren primären Tic-Störungen im klinischen Alltag. Die Diagnose basiert auf der Kombination motorischer und vokaler Tics mit Beginn im Kindes- oder Jugendalter und ist in den meisten Fällen mit hoher Sicherheit möglich. Selten sind Tics die einzigen Symptome bei GTS-Patienten. Bei der Mehrzahl bestehen weitere neuropsychiatrische Komorbiditäten wie ADHS, Zwangs- und affektive Störungen. Störungen aus dem Autismus-Spektrum sind ebenfalls häufig mit Tics assoziiert. Anzahl und Ausmaß der Komorbiditäten können hierbei mit der Intensität und Frequenz der Tics korrelieren und beeinflussen maßgeblich die Lebensqualität. Die Differenzialdiagnose von Tics umfasst zum einen weitere hyperkinetische Bewegungsstörungen wie Myoklonus und Chorea, zum anderen das Spektrum funktioneller Tic-ähnlicher Bewegungen. In dem vorliegenden Artikel beschreiben wir das klinische Spektrum des GTS mit typischen Komorbiditäten und klinische Anhaltspunkte in der Differenzialdiagnose von Tics.

ABSTRACT

Gilles de la Tourette Syndrome (GTS) is the prototypical primary tic disorder encountered in clinical practice. The diagnosis of GTS is based on the hallmark feature of motor and phonic tics, with onset in childhood or adolescence. Tics are rarely the only feature in patients with GTS, and indeed a wide spectrum of neuropsychiatric comorbidities is often present and ranges from attention-deficit hyperactivity disorder and obsessive-compulsive disorder to affective disorders. Autism spectrum disorders are also often associated with the presence of tic behaviors. Often, the number and severity of neuropsychiatric comorbidities may also correlate with tic severity and poor quality of life. The differential diagnosis of tics includes their distinction from other hyperkinesias, such as myoclonus or chorea, and most importantly the entity of functional tic-like movements. Here, we describe the essential clinical characteristics of the movement disorder of tics and their associations in GTS and provide a basic differential diagnostic guide on the clinical approach of tic behaviors.

Schlüsselwörter

Tourette-Syndrom - Tic-Störungen - funktionelle Tic-ähnliche Bewegungen - hyperkinetische Bewegungsstörungen

Key words

Tourette syndrome - tic disorders - functional tic-like movements - hyperkinetic movement disorders

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