Does the child make strange noises, make faces, or make small gestures? may have this disease

time:2023-02-03 author:Baby care
Does the child make strange noises, make faces, or make small gestures? may have this disease

*For reference only for medical professionals

Tourette Syndrome - the culprit of children making strange noises and other behaviors

I wonder if you have read the short video platform circulating A heartwarming movie clip from "Call Me Number One", the little boy Brad suffers from a strange disease. He can't control his strange noises (sometimes swear words), accompanied by involuntary movements of his head and neck, often attracting strange eyes from his classmates. Frequent high-pitched, loud noises. Being ridiculed and ostracized are his daily routines, and he has lost self-confidence because of this, dare not communicate with others, and is reluctant to participate in concerts and other collective activities. It was not until the principal invited him to the stage to share with the students the special disease he suffered from—Tourette Syndrome, and he was finally understood and accepted by the students... 1. What is Tourette Syndrome? sign? Tourette Syndrome (TS) is a neuropsychiatric disease characterized by muscle twitching (involuntary muscle contractions) and is a more serious type of tic disorder (TD). Tics are sudden, purposeless, rapid, and stereotyped muscle contractions. They are divided into motor tics and vocal tics according to the muscle group twitching, and are divided into transient tics (<1 year) and chronic tics (≥1 year) according to the time of onset. . In Tourette's syndrome, there are two or more motor tics and at least one vocal tics, and the onset is usually more than 1 year. Tics (TD) may sound foreign, but they are actually quite common in teens and sometimes even adults. If you look closely, you may notice that someone around you is suffering from motor tics (sudden, uncontrollable movements, such as exaggerated blinks, grins, and hand shakes) or vocal tics (such as throat clearing, grunting, or humming). people.

Common motor tics include:

Facial: blinking, raising eyebrows, shrugging nose, pouting, opening mouth, licking lips Head and neck: shaking head, nodding, head back and limbs : Raise hands, shrugs, lift feet, move fingers/toes Others: Squeeze stomach, expand stomach, touch certain parts/body parts involuntarily

Common vocal tics include:

Throat clearing, coughing, screaming, imitating animal calls, making strange sounds such as "ah, da"... The symptoms of tics are not static, and the form and frequency of tics can change over time. Originally only one symptom of tics, another symptom may appear at intervals, and it is often exacerbated by illness or emotional stress. Transient tics can evolve into chronic tics, and simple motor tics or vocal tics can also evolve into Tourette's syndrome. Parents often report that the child just blinked at first, but then it was all right, and suddenly started to fiddle with the nose again, the nose stopped, and the throat sounded again. This is the variability and instability of tics. Second, can Tourette syndrome be treated? The little boy Brad in the film once mentioned that "there is no cure for my disease", but in fact, even as the most serious and intractable type of tics, Tourette's syndrome can still be treated . Commonly used treatment methods include: educational counseling, psychological support therapy, behavioral therapy such as habit reversal training, drug therapy, botulinum toxin injection, and deep brain stimulation if treatment fails. For mild tics that do not cause functional impairment, observational treatment can be provided through education, medical consultation, and support. When it affects physical and mental function, behavioral therapy, such as habit reversal training, can be used. The core is to teach patients to recognize the early signs of tics and use acceptable movements to replace them. If behavior therapy is not possible, use drug therapy. Studies have shown that the remission rate of drug therapy is 50% to 80%. In addition, the symptoms of tics can be alleviated or alleviated with age and the gradual improvement of brain development. Three outcomes in children with TD into adulthood: 50% to 60% of patients have complete remission; 30% to 50% of patients have disease remission; 5% to 10% of patients have delayed disease into adulthood or life, with no change in disease or disease. Aggravated, can affect the patient's work and quality of life due to tic symptoms or comorbidities (anxiety disorder, obsessive-compulsive disorder, etc.). The prognosis of children with TD is related to risk factors such as comorbidities, family history of psychiatric or neurological disorders, and severity of tics. The author has seen a typical patient with Tourette syndrome, who involuntarily made a burp-like sound while sitting on a chair in the consulting room, almost at the same time the hips were 3cm-5cm away from the chair (the whole person bounced), and then the upper body shook, so repeatedly. The child was unable to continue his studies because his symptoms were too severe. After a period of comprehensive treatment, although the child has not been able to return to school smoothly, the frequency of tics has been significantly reduced, and he can continue his studies at home through online classes. Third, under what circumstances do you need to consider that your child may have tics? Most tics are mainly manifested by frequent blinking in the early stage, which needs to be differentiated from eye fatigue and conjunctivitis. It is usually recommended to visit an ophthalmologist for a complete examination. There are also many patients who have nose sniffing or nose shrugging, which looks like their nose is uncomfortable. They often need to go to the otolaryngology department to identify whether they have allergic rhinitis, adenoid hypertrophy and other problems. Children with throat clearing, humming, or coughing need to identify respiratory diseases such as chronic pharyngitis and chronic cough. When the symptoms appear repeatedly, and the cause is not found after the evaluation of the relevant specialists, or the above-mentioned multiple symptoms appear successively, it is necessary to highly suspect the possibility of tic disorder, and it is recommended to refer to the neurology department or psychiatry department for treatment. Fourth, if the child is diagnosed with tic disorder, what can parents do? Tic disorder is a common neurodevelopmental disorder in childhood. It is related to genetic factors. If one parent has tic disorder, the incidence of TD in children is also increased. At the same time, the onset and development of TD are affected by psychological and social factors. Therefore, while completing the doctor's order, parents can help their children reduce TD symptoms through behavior management. 1. Adjust parenting style: Parents of patients with tics can often observe a phenomenon that the more criticism and blame, the more severe the child's TD symptoms. Appropriate relaxation requirements and parenting in a warm, encouraging way can help ease your child's TD symptoms. 2. Cultivate regular work and rest: Children’s excessive activity and irregular work and rest time will lead to excessive physical fatigue and excessive excitement of the cerebral cortex, which is more likely to aggravate TD symptoms. Clinically, parents often respond that they are fine during the day, especially at night. Symptoms are especially noticeable when going to bed. Regular work and rest, coordination of activities and rest, and combination of work and rest are more conducive to the stability of nerve function. 3. Healthy eating habits: Some studies have shown that the occurrence of TD may be related to the insufficiency of nutrients (especially zinc and iron). Excessive consumption of processed foods with various additives may inhibit the absorption of certain nutrients. Although it is not necessary to supplement these nutrients, eating fresh fruits and vegetables and fresh meat without excessive processing is more conducive to nutritional balance. 4. Reduce the use of electronic products: Parents can notice that TD children have more symptoms such as blinking and sniffing when playing mobile phones, tablets or watching TV, which may be related to brain overexcitation, nervousness, and visual fatigue. Although the relationship between electronic products and TD is still unclear, it is also necessary to control the use of electronic products from the perspective of children's vision development. It is recommended not to exceed 1 hour a day. 5. Help children to channel their emotions: TD children often have anxiety, nervousness, and even aggressive behavior because they cannot handle their emotions. It is very meaningful to pay attention to children's emotions and teach them to properly handle negative emotions. Reference 1. Lu Qing, Sun Dan, Liu Zhisheng. Interpretation of expert consensus on diagnosis and treatment of tic disorders in China [J]. Chinese Journal of Practical Pediatrics, 2021, 36(9): 647-653. DOI: 10.3760/cma.j. cn101070-20201229-01967.2. Zhai Qian, Feng Lei, Zhang Guofu. Advances in etiology and treatment of tic disorder in children. Chinese Journal of Practical Pediatrics, 2020,1,35(1):66-72.3.Zaky,Mahmoud. Tourette Syndrome: A Case Report , When Exclusion of Differential Diagnoses and Comorbidities Really Matters. J Child Adolesc Behav 2017, 5:4. Source of this article: Pediatrician Kong Lingkai Author of this article: Yao Jiawen, Chief Physician of Pediatric Neurology, Dongguan Children's Hospital Responsible Editor: Xiang Yu Copyright statement This article is welcome to reprint Forward Moments - End - The medical community strives for the accuracy and reliability of its published content when it is approved, but does not make any commitments and guarantees for the timeliness of the published content and the accuracy and completeness of the cited materials (if any). , and does not assume any responsibility for the outdated content, possible inaccuracies or incompleteness of the cited materials. Relevant parties are requested to check separately when adopting or using it as a basis for decision-making.
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