Tiques e síndrome de Gilles de la Tourette

Abstract

The concept of tic was developed at the end of the XIX century, emerging from the "chaos of choreas". Tic is defined as involuntary contractions of agonist and antagonist muscles in one or more parts of the body. It can be suppressed by voluntary efforts for seconds or hours, followed by exacerbations. Gilles de la Tourette's original article was published in 1885, in which he described nine patients with tics, and vocalisations. The pathogenesis of Gilles de la Tourette syndrome remained obscure. However, three factors have been considered: the neurochemical factor, related to the increased dopaminergic activity at the basal ganglia; the genetic factor and the non-genetic factors, for which environment more than genetic factors are involved. Pathologic examinations failed to reveal structural lesions, but PET studies showed metabolic hypofunction on the frontal, cingulate and possibly insular cortex, and on the inferior corpus striatum. The motor tics as well as the vocal tics can be simple or complex and are present in all patients. Other signs can be added to the previous tics: sensory tics, echophilia, coprophilia, obsessions, compulsions and impulsions. Diagnostic criteria of Gilles de la Tourette syndrome are based on: age of onset; presence of motor and vocal tics; voluntary suppression of the movements; variation in number, type, location and severity of tics; duration of more than one year. Haloperidol is the drug of choice for the treatment of Tourette's syndrome.

Tics and Tourette syndrome: clinical evaluation of 44 cases

“…TS and other tic disorders seem to be part of the same phenomenological continuum, and some clinical features of tics, OCD and ADHA can occur in any given person during childhood as part of the normal development 18,19 . In addition, other studies highlight the role of both genetic and environmental factors in the genesis of tic disorders [7][8][9][13][14][15]18,20,21 .…”

Síndrome de La Tourette: revisão de literatura

“…Can be suppressed by will (for seconds or hours), soon followed by secondary exacerbations. Others manifestations, like, echolalia, echopraxia, coprolalia and copropraxia can, also, be present (26).…”

Doença dos tiques: aspectos genéticos e neuroquímicos atuais

“…Quando contava apenas 28 anos, deixou seu nome na história da Neurologia ao publicar seu mais importante trabalho entitulado " Étude sur une affection nerveuse caractérisée par l'incoordenation motrice accompagnée d'echolalie et de coprolalie". Em nenhum momento utilizou o termo tique, preferindo incoordenação motora, convulsões, contorções e descargas musculares [1][2][3][4] . Os tiques são definidos como movimentos anormais, clônicos, breves, rápidos, súbitos, sem propósitos e irresistíveis.…”

“…São exacerbados por situações de ansiedade e tensão emocional; atenuados pelo repouso e por situações que exigem concentração. Podem ser suprimidos pela vontade (por segundos ou horas), logo seguidos por exacerbações secundárias 3,5 .…”

“…Coprofilia, também, é um termo genérico criado para significar a coprolalia e a copropraxia. Dentre os distúrbios do comportamento, destacam-se o TOC e a HDA 3,[5][6][7] .…”