Tourette's syndrome is a disease
found in 1885 and named after their discoverer, the neuroscientist of France,
Georges Gilles de la Tourette. The disease is characterized by motor and motion
sounds over and over again that often. Tourette syndrome is a neurological
disorder that arose in childhood that has been characterised by motor movement
and sound that repeats as well as one or more nerve traction (tic) that
increased and decreased severe condition at a certain period of time.
Neurological decline marked by muscle nerves spasm of simple and complex vocal
and often happens all day long for at least one year. This syndrome affects one
in 100 people and the majority of which occur in males. Tourette syndrome is
mostly started as children and usually the symptoms that arise is not
recognized because the symptoms are very mild.
A nervous disorders and behavior
(neurobehavioral disorder) is characterized by its action cannot be realized,
took place rapidly (brief involuntary actions), a form of vocal and motor tics,
also accompanied by psychiatric disorders (psychiatric disturbances). The
nervous movements occur suddenly, often, repetitive, irregular, characterized
by the movement of the motor and vocal. Example, nervous movements that occur
as the blink of an eye, nose scrunching, repetitive movements of the head,
throat and cough murmuring noises. The nervous movements generally occur in one
day, where the longer the movement was growing and could be reduced depending
on the level of severe condition. Typically, individual patients, the movement
of these nerves can change, usually a couple of nervous movement disappeared
and new ones appear at one time.
Tourette Syndrom symptoms usually
do not cause physical damage. However, in some cases for example when
individuals with Tourette's Syndrom being using knives or other cutting tools
can potentially cause injury. Some patients need medication when the symptoms
appear is very disturbing.
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| Tourette's Syndrome |
Drugs that are needed by people
with Tourette's Syndrom among others Neuroleptik the drugs used to treat
psychotic disorders. Neuroloptik also have side effects that are often called dyskinesia
dyskinesia, i.e. different from tic movement usually due to excessive use of
neuroleptik. In addition when the drug is no longer used by pasie will also
give rise to a kind of dependence. Therefore the discontinuance of neuroleptik
should be done slowly. Other drugs commonly used to treat the symptoms of
Toourrete Syndrom among other Guanfacine, Atomoxetine Clomipramine, Fluoxetine,
Setraline, Fluoxamine. The experts also utilizes Cognitive Behavioral Therapy
(CBT) and relaxation techniques to reduce the symptoms of disorders of Tic. But
the results of these methods have not been systematically evaluated and is not
supported empirically to heal Tourrete Syndrom.
Criteria for diagnosis of
Tourette's disease is as follows:
1. Tourette’s appear before the age of 18 years.
2. Cause of the disease is
characterized by intrusive stress or social unsuitability, relations with
others relating to the importance of the area function
3. Have more than one motion motor and one or
more motion of the vocal nerves that have appeared at any given time during the
illness, although it is not necessarily the case.
4. Nervous Motion occurs in a lot
of hours in the day or on any day during the period of alternating sometime for
over a year, and during that period there was no period of time is independent
of the motion of nerves over of the month.
5. A disturbing hing is not
dependent on the influence of physical or medication (such as stimulants) or a
general medical condition (such as a disease or postiviral Hutington
encephalitis).
In the etiology of the symptoms
of Tourette's Syndrome causes include:
Genetic: 50% on twin monozigot,
8% in dizigot. Neurokimiawi: weak dopamine settings in the caudate nucleus.
According to Moe PG, et.al. (2007), Tourette's syndrome can be triggered
(triggered) by stimulants such as methylphenidate and dextroamphetamine, in
addition also there is imbalance (imbalance) or hypersensitivity to the neurotransmitters
dopamine and serotonin, particularly.
Research carried out A Cuker
et.al. (2004), managed to find a candidate locus for Gilles de la Tourette
syndrome/obsessive compulsive disorder/chronic tic disorder, i.e. on the locus
of 1822.
With increasing age, simptom can
decline depending on the intensity of the severity of the nerve type of
movement. The age of onset of this nervous motion between 2 and 15 years. That
reduced neuronal movement during sleep and may be pressed for a short period
during the patient unconscious.
On almost all children, tourette
syndrome is recurring motion, where anxiety, stress, and fatigue often increase
the occurrence of neurological movement. Between 5 to 10% of patients not
undergoing change or even got worse up to the age of adolescence and adulthood.
In older patients, nervous movements tend to be more stable over time, while it
may be a new form of nervous movement emerged. There is no way you can predict
that sufferers of childhood can have a worse prognosis.
Nerve disease and tourette
syndrome are usually accompanied by other conditions. The three conditions that
accompany ADHD among others (tourette syndrome sufferers 50% also suffer from
ADHD), learning difficulties (25-30% of patients), and obsessive-compulsive
(25-40%).
In addition to administering the
drugs should continue to be given, psychologically therapy should also be made
and given to assist the process of tourette syndrome disease prevention is not
getting worse. These interventions include:
1. Psycoeducation
The main thing is that the
Government should have a program that aims to provide the knowledge and
understanding to all communities regarding mental health. These programs can
include the Department of social, Social Department, in areas of health. Not
only that, the Government can introduce each existing disease through specific
ways to increase public knowledge and making the community more understanding
and more concerned with the environment. This is because the community must
actually give support morally for sufferers of a disease, in this case the
tourette syndrome is to prevent increased the severity of the disease. The
public should be told that tourette syndrome is not a communicable disease that
needs to be feared.
2. Relationships with family
Families can help sufferers to
fight negative things that could disrupt the stability of the sufferer. A
number of children who suffered damage neuropsychiactirc (nerve) and her family
is indeed need to get encouragement and services especially those who are
experiencing growth in current.
3. School Interventions
But it will be better when
tourette syndrome sufferers can interact with friends in the class if it has
not been severe condition level is too high. This is so that the severity of
the ailment did not increase as it makes the sufferer feel got the support and
attention of friends at his school.
4. Behavior Therapy
The granting of positive
reinforcement program becomes a way that can help the nervous movement
irregularities. The behavior of the target might be included categories into
two groups, namely the deficiency or area of expertise, specifically a
concentration to train social and academic skills, and behavior outside the
limits, it aims to help patients reduce the frequency of appearance of
behaviors that are owned.
Can be used for simple scale
ranked a troubled behavior, made on the basis of consideration of response to
intervention. This approach can help a child with developmental problems
double. For kids with chronic problems, this scale helps especially when
started it is hard to tell how much progress there has been. Other important
rules, such as parents and teachers must complete three ratings for boy who
became a patient. This data, and then will be combined with the assessment of
medical experts will know the basis of the severity of his illness. The rating
scale may also be used to evaluate changes in the intervention and response
time monitoring all the time about the severity of his illness.
5. Psychotherapy
The therapist should use a
particular behaviours techniques (such as Hypnotherapy and relaxation) and
there will be other alternative treatments that can be done (such as
acupuncture and dietary supplements). Cognitive behavioral techniques can be
developed for specific use for certain patients with tourette syndrome.
6. Monitoring
Though it is not something that
an emergency, such as a self-destructive behavior or unexpected circumstances,
the therapist can follow patients for several months prior to the treatment has
been designed. Some of the goals of the first phase of treatment are to: make
the basis of the existing symptoms; find things related to difficulty in
school, family, and relationships with friends; provide psychological and
medical tests; monitor and fluctuation symptoms most often; and form
relationships.
and the most frequent simptom
fluctuations; and form relationships.
7. Habit Reversal
Habit reversal is composed of
several components, namely the training of consciousness awareness training and
monitoring against yourself, relaxation training, alternate response procedures
(competing response), sustainable management, and monitoring of the discomfort.
The patient will be given such things as homework.
8. Supportive Therapy
In this form of therapy support
condition, sufferers choose the topic of discussion in a meeting and the
sessions focus on experience, reflection, and expressing feelings about what
happens in life and how to troubleshoot the problem.
Source of information comes
from
-Cuker A, et.al. Candidate locus for Gilles de la Tourette
syndrome/obsessive compulsive disorder/chronic tic disorder at 18q22. Am J Med
Genet A 2004; 130: 37.
-Albin RL, Mink JW: Recent advances in Tourette's syndrome research.
Trends Neurosci 29: 175, 2006.
-Moe PG, Benke TA, Bernard TJ.
Neurologic and Muscular Disorders. In: Current Diagnosis and Treatment in Pediatrics.
18th edition. Edited by: Hay WW, Levin MJ, Sondheimer JM, Deterding RR.
International Edition. Lange Medical Books-McGraw-Hill. USA. 2007;23:761-762.
