Tics
Description:
Tics — the repeating bystry involuntary spasmodic movements usually involving narrow group of muscles. Allocate motor tics, vocal tics, touch tics (the unpleasant corporal feelings passing at commission of a motor or vocal tic). The tics entering each of these groups divide on simple and difficult.
Symptoms of Tics:
The blinking, twitching by the head, a pozhimaniye shoulders, retraction of a stomach, a zazhmurivaniye, examples of difficult motor tics can be examples of simple motor tics —. blows in the body, jumping, ekhopraksiya (repetition of gestures), kopropraksiya (reproduction of indecent gestures). The tussiculation, snorting, a pokhryukivaniye, whistle belong to simple vocal tics; to difficult — an echolalia (repetition of someone else's words), a pallilaliya (repetition of the words or sounds), an eschrolalia (pronouncing obscene words). The group of primary tics arising in the absence of certain primary disease is subdivided into the tranzitorny motor and/or vocal tics proceeding less than 1 years, the chronic motor or vocal tics remaining without long remissions for 1 year and more and also Turett's syndrome representing a combination of chronic motor and vocal tics. These options of tics begin, as a rule, at children's and teenage age. The syndrome of persuasive states, the syndrome of a hyperactivity, impulsiveness and disturbance of attention complicating training of patients are often combined with tics. Usually tics develop gradually at children's age and remain unnoticed until parents suddenly do not pay attention that the child after a respiratory infection began to sniff constantly or after the postponed stress began to blink continuously. Tics quite often amplify at teenage age, and at youthful and young age decrease.
Reasons of Tics:
Nosologically allocate primary and secondary tics. Secondary tics are connected with reception of medicines (antiepileptic means, neuroleptics and other antidofaminergichesky drugs, drugs of a levodopa, psychostimulants), a craniocereberal injury, encephalitis, vascular diseases, a poisoning with carbon monoxide, perinatal pathology.
Treatment of Tics:
In many cases of drug treatment enough the patient and his parents is not required and to calm, having told about the nature of a disease and having pointed to its high-quality current. It is important to mention that the patient is not threatened by decrease in intelligence, a serious mental or neurologic illness, and in most cases patients perfectly adapt in life. It is important to warn parents that it is not necessary to focus attention of the child on tics. In the long-term plan a problem of treatment is not suppression of tics, but creation of conditions for normal training and education of self-checking. The role of drug treatment has to be limited as there are no effective remedies which at the same time would be absolutely safe. Neuroleptics — the most effective remedies suppressing tics should not be used without emergency. At the initial stage it is possible to be limited to rather safe means having moderate effect. Phenibutum, clonazepam, clonidine concern to them. Short reception of low doses of neuroleptics — a tiaprid, Sulpiridum (eglonyl), Pimozidum (blackamoor), a haloperidol is shown to a part of patients. Only in hard cases long reception of neuroleptics is justified, but at the same time it is necessary to adhere to a minimal effective dose. The side effects appearing during an initial stage of treatment (dystonic reactions, parkinsonism symptoms, a sight illegibility, a dysarthtia) can be eliminated by means of cholinolytics (Cyclodolum or Akinetonum). As an additional tool apply chewing gum or a plaster with the nicotine strengthening action of neuroleptics. Apply to treatment of a syndrome of persuasive states кломипрамин (anafranit), sertraline (золофт), флувокасамин, for treatment of disturbance of attention at school students — tricyclic antidepressants (Melipraminum or desipramine) or easy psychostimulants.
