Gilles de la Tourette’s syndrome

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

Zyprexa (Olanzapine) Bipolar disorders Gilles de la Tourette s syndrome Psychotic disorders 1.9 0.6 1996 - UK and US Once daily... 

Hyde, T.M., Aaronson, B.A., Randolph, C., Rickler, K.C., and Weinberger D.R. (1992) Relationship of birth weight to the phenotypic expression of Gilles de la Tourette s syndrome in monozygotic twins. Neurology 42 652-658. 

Peterson, B.S. and Leckman, J.F. (1998) Temporal characterization of tics in Gilles de la Tourette s syndrome. Biol Psychiatry 44 1337-1348. 

Burd, L., Kerbeshian, L., Wikenheiser, M., and Fisher, W. (1986a) Prevalence of Gilles de la Tourette s syndrome in North Dakota adults. Am J Psychiatry 143 787-788. 

Shapiro, E., Shapiro, A.K., Fulop, G., Hubbard, M., Mandeli, J., Nordlie, J., and Phillips, R.A. (1989) Controlled study of haloperidol, pimozide, and placebo for the treatment of Gilles de la Tourette s syndrome. Arch Gen Psychiatry 46 722-730. 

Como, P.G. and Kurlan, R. (1991) An open-label trial of fluoxetine for obsessive-compulsive disorder in Gilles de la Tourette s Syndrome. Neurology 41 872-874. 

Erenberg, G., Cruse, R.P., and Rothner, A.D. (1985) Gilles de la Tourette s syndrome effects of stimulant drugs. Neurology 35 1346-1348. 

Serotonin-dopamine antagonist and Gilles de la Tourette s syndrome an open pilot dose-tltratlon study with risperidone. Moi Disord 9 687-688. 

Pauls DL, Towbin KE, Leckman JF, et al Gilles de la Tourette s syndrome and obsessive-compulsive disorder evidence supporting a genetic relationship. Arch Gen Psychiatry 43 1180-1182, 1986... 

It is indicated in acute and chronic schizophrenia, anxiety disorders, acute mania, hypomania and behavioural disorders in children antiemetic neuroleptanalgesia, Gilles de la Tourette s syndrome and Huntington s disease. 

Pauls DL, Leckman JF. The inheritance of Gilles de la Tourette s syndrome and associated behaviors evidence for autosomal dominant transmission. N Engl J Med 1986 315 993-997. 

Frankel M, Cummings JL, Robertson MM, et al. Obsessions and compulsions in Gilles de la Tourette s syndrome. Neurology 1986 36 378-382. 

Leckman JF, Hardin MT, Riddle MA, et al. Clonidine treatment of Gilles de la Tourette s syndrome. Arch Gen Psychiatry 1991 48 324-328. 

Tics are sudden coordinated abnormal movements that tend to occur repetitively, particularly about the face and head, especially in children, and can be suppressed voluntarily for short periods of time. Common tics include repetitive sniffing or shoulder shrugging. Tics may be single or multiple and transient or chronic. Gilles de la Tourette s syndrome is characterized by chronic multiple tics its pharmacologic management is discussed at the end of this chapter. 

The pathophysiologic basis of tics is unknown. Chronic multiple tics (Gilles de la Tourette s syndrome) may require symptomatic treatment if the disorder is severe or is having a significant impact on the patient s life. Education of patients, family, and teachers is important. 

Goetz CG, Stebbins GT, Thelen JA. Talipexole and adult Gilles de la Tourette s syndrome double-blind, placebo-controlled clinical trial. Mov Disord 1994 9(3) 315-17. 

Other Echolalia, learning problems (children), paraphilias, insomnia, loss of libido, fatigue, Gilles de la Tourette s syndrome, Kliiver-Bucy syndrome, astasia-abasia... 

Gilles de la Tourette s syndrome is characterized by involuntary movements, echolalia, echopraxia, coprolalia, and strange, uncontrollable sounds. The differential diagnosis includes the various movement disorders that can present in childhood. Other disorders characterized by tics are distinguished by resolution of the tics by early adulthood or by the restricted number of tics. 

Wilson s disease can simulate Gilles de la Tourette s syndrome it must be excluded because it responds well to medical treatment. In addition to a movement disorder, Wilson s disease produces hepatic involvement, Kayser-Fleischer corneal rings, and abnormalities of serum copper and ceruloplasmin, which are absent in Gilles de la Tourette s syndrome. 

Bobble-head syndrome, which can be difficult to distinguish from Gilles de la Tourette s syndrome, is characterized by rapid, rhythmic bobbing of the head in children with progressive hydrocephalus. Treatment is symptomatic and, if effective, must be continued iudefiuitely. 

Haloperidol blocks dopamine receptors in the brain and hence produces a very high incidence of movement disorders such as parkinsonism (see phenothiazine derivatives). Its mechanism of action in Gilles de la Tourette s syndrome is unknown. In addition to blocking dopamine receptors, haloperidol has many other central and peripheral effects it has weak peripheral anticholinergic and antiemetic... 

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