Tourette syndrome: Review of literature

Summary

Introduction: Tourette Syndrome (TS) was described for the first time in 1825, and it is a neuropsychiatry disease, initially begins in childhood, affects more males, characterized by remarkable social and psychological commitment, impacting the lives of patients and family. Until recently, this disease were considered a rare condition, but current studies show that the prevalence rate may vary in 1% to 2,9% in a few groups.

Objective: Perform a review of literature over the main aspects related to Tourette syndrome.

Data synthesis: The TS is a genetic disorder, associated with neuroanatomical and neurophysiological alterations, characterized by compulsive phenomenon, whose etiology is still unknown. The clinical profile is composed, mostly, by motor tics and vocal tics, that which are divided in simple and complex. Its association with Obssessive Compulsive Disorder and Attention Deficit Hyperactivity Disorder is very commom. The diagnosis is mainly clinical and do not exist. Until now, there is no specific laboratory test that confirm this pathology. The treatment is based mainly on psychological theory. However when there is need for the use of drugs, the most widely used are the antagonists of dopamine receptors.

Conclusion: The TS causes many damages as psychosocial and educational for the individual and the family. However, the diagnosis and the early treatment are able to minimize or cancel this damages. This way, knowing the general aspects that guide the TS is of utmost importance to preserve the quality of life for the patients with the disease.

Resumo

Introdução: A Síndrome de La Tourette (ST) foi descrita pela primeira vez em 1825 e se trata de uma patologia neuropsiquátrica de início geralmente na infância, que acomete mais o sexo masculino, caracterizada por notável comprometimento psicológico e social, causando impacto na vida dos portadores e familiares. Até pouco tempo, essa patologia era considerada uma condição rara, porém, estudos atuais demonstram que a taxa de prevalência pode variar de 1% a 2,9% em alguns grupos.

Objetivo: Realizar uma revisão de literatura sobre os principais aspectos relacionados à Síndrome de La Tourette.

Síntese dos dados: A ST é um distúrbio genético, associado a alterações neurofisiológicas e neuroanatômicas, caracterizado por fenômenos compulsivos, cuja etiologia ainda é desconhecida. O quadro clínico é composto, principalmente, por tiques motores e vocais que se subdividem em simples e complexos. A sua associação com Transtorno Obsessivo Compulsivo e Transtorno do Déficit de Atenção e Hiperatividade é relativamente comum. O diagnóstico é eminentemente clínico e não existe, até o momento, nenhum teste laboratorial específico que confirme esta patologia. O tratamento é fundamentado, principalmente, na terapia psicológica. Porém, quando há necessidade do emprego de fármacos, os mais utilizados são os antagonistas dos receptores de dopamina.

Conclusão: A ST causa diversos prejuízos psicossociais e educacionais para o indivíduo e familiares. Porém, o diagnóstico e tratamento precoces são capazes de minimizar ou anular estes danos. Desta forma, conhecer os aspectos gerais que norteiam a ST é de fundamental importância para preservar a qualidade de vida dos portadores da doença.

Keywords

Tourette syndrome - tics - otorhinolaryngologic diseases - voice disorders

Palavras-chave

síndrome de Tourette - tiques - otorrinolaringopatias - distúrbios da voz

• Bibliographic References

• 1 Itard JG. Mémoire sur quelques functions involuntaires des appeirls de la locomotion de la prehension et de la voix. Arch Gen Med 1825; 8: 385-407
• 2 Gilles de La Tourette GAB. Étude sur une affection nerveuse caractérisée par de Iincoordination motrice accompagnée décholaic et coprolalic. (Jumping, Latah, Myriachit). Arch Neurol 1885; 9: 19-42
• 3 Loureiro NIV, Matheus-Guimarães C, Santos DO, Fabri RGF, Rodrigues CR, Castro HC. Tourette: por dentro da síndrome. Rev Psiquiatr Clín 2005; 32 (4) 218-230 . Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-60832005000400004&lng=en
• 4 Ramalho J, Mateus F, Souto M, Monteiro M. Intervenção educativa na perturbação Gilles De La Tourette. Rev Bras Educ Espec 2008; 14 (3) 337-346 . Disponível em: < http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-65382008000300002&lng=en&nrm=iso >.
• 5 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed, Text Revision. Washington, DC: American Psychiatric Association; 2000
• 6 Hounie A, Petribú K. Síndrome de Tourette revisão bibliográfica e relato de casos. Rev Bras Psiquiat 1999; 21 (1) 50-63
• 7 Singer HS, Minzer K. Neurobiology of Tourettes syndrome: concepts of neuroanatomic localization and neurochemical abnormalities. Brain & Development 2003; 25 (1) S70-84
• 8 Leckman JF, Cohen DJ. Tourettes Syndrome - Tics, Obsessions, Compuslions: Developmental Psychopathology and Clinical Care. New York, NY: Wiley; 1999
• 9 Mattos JPD, Mattos VMDBC. Doença dos tiques: aspectos genéticos e neuroquímicos atuais. Arq. Neuro-Psiquiatr 1999; 57 (2B): 528-530 . Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282�1999000300029&lng=en
• 10 Miranda M. Tics, Obsesiones y Síndrome de Gilles de la Tourette: Actualización Clínica. Rev. chil. Neuro-psiquiatr 2000; 38 (2) 112-121 . Disponível em: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-92272000000200006&lng=es
• 11 Robertson MM, Stern JS. Tic disorders: new development in Tourette syndrome and related disorders. Curr Opin Neurol 1998; 11 (4) 373-80
• 12 Robertson MM. Diagnosing Tourette syndrome: is it a common disorder?. J Psychosom Res 2003; 55 (1) 3-6
• 13 Eapen V, Foxhiley P, Banerjee S, Robertson M. Clinical features and associated psychopathology in a Tourette syndrome cohort. Acta Neurol Scand 2004; 109 (4) 255-60
• 14 Kadesjo B, Gillberg C. Tourettes disorder: epidemiology and comorbidity in primary school children. J Am Acad Child Adolesc Psychiatry 2000; 39 (5) 548-55
• 15 Freeman RD, Fast DK, Burd I , et al. An international perspective on Tourette syndrome: selected findings from 3500 Individuals In 22 Countries. Dev Med Child Neurol 2000; 42 (7) 436-47
• 16 Robertson MM. Tourette syndrome, associated conditions and the complexities of treatment. Brain 2000; 123 (3) 425-62
• 17 Scahill L, Tanner C, Dure L. The epidemiology of tics and Tourette syndrome in children and adolescents. Adv Neurol 2001; 85: 261-71
• 18 Mason A, Banerjee SP, Eapen V, Zeitlin H, Robertson MM. The prevalence of Gilles de la Tourettes syndrome in a mainstream school population. A pilot stud. Dev Med Child Neurol 1998; 40 (5) 292-6
• 19 Kushner HI. Medical fictions: the case of the cursing marquise and the (re)construction of Gilles de la Tourttes syndrome. Bull Hist Med 1995; 69 (2) 224-54
• 20 American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM IV), American Psychiatry Association, Washington, DC, 1994.
• 21 World Health Organization International classification of diseases and health related problems, 10th revision, World Health Organization, Geneva, 2000.
• 22 Peterson BS. Neuroimaging studies of Tourette syndrome: a decade of progress. Adv Neurol 2001; 85: 179-96
• 23 Pauls DL. An update on the genetics of Gilles de la Tourette síndrome. J Psychosom Res 2003; 55 (1) 7-12
• 24 Leckman JF, Peterson BS, King RA , et al. Phenomenology of tics and natural history of tic disorders. Adv Neurol 2001; 85: 1-14
• 25 Mercadante MT, Rosario MCC, Quarantini LC, Sato FP. The neurobiological bases of obsessive compulsive disorder and Tourette syndrome. J Pediatr.. 2004; , (2 Suppl): S35-44
• 26 Mattos JP, Rosso ALZ. Tiques e síndrome de Gilles de La Tourette. Arq Neuropsiquiatr 1995; 53: 141-146
• 27 Jankovic J. Phenomenology and classification of tics: Tourette syndrome. Neurol Clin N Am 1997; 15: 267-275
• 28 Fen CH, Barbosa ER, Constantino ME. Síndrome de Gilles de la Tourette: estudo clínico de 58 casos. Arq. Neuro-Psiquiatr 2001; 59 (3B): 729-732 . Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282�2001000500015&lng=en .
• 29 Díaz-Anzaldúa A, Joober R, Riviere JB , et al. Tourette syndrome and dopaminergic genes: a family-based association study in the French Canadian founder population. Mol Psychiatry 2004; 9 (3) 272-7
• 30 Cuker A, State MW, King RA, Davis N, Ward DC. Candidate locus for Gilles de la Tourette syndrome/obsessive compulsive disorder/chronic tic disorder at 18q22. Am J Med Genet A 2004; 130 (1) 37-9
• 31 State MW, Greally JM, Cuker A , et al. Epigenetic abnormalities associated with a chromosome 18(q21–q22) inversion and a Gilles de la Tourette syndrome phenotype. Proc Natl Acad Sci USA 2003; 100 (8) 4684-9
• 32 Hoekstra PJ, Anderson G, Limburg PC , et al. Neurobiology and neuroimmunology of Tourettes syndrome: an update. Cell. Mol. Life Sci 2004; 61: 886-98
• 33 Muller N, Riedel M, Straube A, Wilske B. Poststreptococcal autoimmune phenomena in patients with Tourette Syndrome. Psychiatry Res 2000; 94: 43-49
• 34 Muller N, Riedel M, Blendinger C, Oberle K, Jacobs E, Abele-Horn M. Mycoplasma pneumoniae infection and Tourettes syndrome. Psychiatry Res 2004; 129: 119-125
• 35 Miranda MC, Menéndez PG, David PG, Troncoso MS, Hernández MC, Chaná PC. Enfermedad de los tics (síndrome de Gilles de la Tourette): características clínicas de 70 pacientes. Rev. méd. Chile 1999; 127 (12) 1480-1486 . Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98871999001200010&lng=es
• 36 Gerard E, Peterson BS. Developmental processes and brain imaging studies in Tourette syndrome. J Psychosom Res 2003; 55 (1) 13-22
• 37 Bloch MH, Leckman JF, Zhu H, Peterson BS. Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome. Neurology 2005; 65: 1253-1258
• 38 Associação Americana de Psiquiatria. Manual de Diagnóstico e Estatística das Perturbações Mentais - DSM-IV-TR. 4ª ed. Lisboa: Climepsi; 2002
• 39 Kimaid PAT, Quagliato EMAB, Crespo AN, Wolf A, Viana MA, Resende LAL. Laryngeal electromyography in movement disorders: preliminary data. Arq. Neuro-Psiquiatr 2004; 62 (3a): 741-744 . Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282�2004000400034&lng=en
• 40 Burd L, Kerbeshian J. Gilles de la Tourettes syndrome and bipolar disorder. Arch Neurol 1984; 41 (12) 1236
• 41 Robertson MM. Mood disorders and Gilles de la Tourettes syndrome: An update on prevalence, etiology, comorbidity, clinical associations, and implications. J Psychosom Res 2006; 61 (3) 349-58
• 42 Alzuri FM, Valdés MR. Trastorno de Gilles de la Tourette: aspectos patogénicos y terapéuticos. Presentación de 1 caso. Rev Cubana Pediatr 2001; 73 (1) 64-68 . Disponível em: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312001000100011&lng=es
• 43 Boarati MA, Castillo AR, Lage G, Castillo JCR, Lee FI. Síndrome de Gilles de La Tourette em criança portadora do transtorno do humor bipolar. Rev Bras Psiquiatr 2008; 30 (4) 407-408 . Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S151644462008000400024&lng=en
• 44 Jankovic J. Differential diagnosis and etiology of tics. Adv Neurol 2001; 85: 15-29
• 45 Holguín JA, Osío OU, Sánchez YM, Carrizosa JM, Cornejo WO. Comorbilidad del trastorno de hiperactividad con déficit de atención (THDA) en una muestra poblacional de niños y adolescentes escolares, Sabaneta, Colombia, 2001. Iatreia. Rev Fac Med Univ Antioqui 2007; 20 (2) 101-110 . Disponível em: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-07932007000200001&lng=en