Tourette's disorder is a chronic refractory neuro-behavioral disease. New treatment strategies, such as repeated transcranial magnetic stimulation (rTMS), have been introduced recently. We report the effect of rTMS in a case with Tourette's disorder and attention deficit hyperactivity disorder (ADHD), a common combination in the clinical setting. This was a treatment-refractory patient, who had undergone 2 years of drug treatment and psychiatric consultation. We administered 10 sessions of rTMS for 10 days, resulting in a clear improvement in symptoms not only of Tourette's disorder but also of ADHD. Our observations indicate that rTMS may be effective in the treatment of Tourette's disorder with ADHD.
Attention Deficit Disorder with Hyperactivity ; Humans ; Tourette Syndrome ; Transcranial Magnetic Stimulation

Tic disorder is a childhood neuropsychological disorder characterized by abrupt, involuntary, and repetitive stereotyped muscle movement or vocal sound. Tourette's disorder shows a chronic prognosis, and can last for life if no treatment is applied. Although tic disorder has been known for ages, the underlying cause is still not well known. Non-pharmacological treatments have long been used for the tic disorder, but few clinical studies were conducted. However, the European Society for the Study of Tourette's Syndrome recently issued non-pharmacologic guidelines for treatment of tic disorders based on the research findings obtained so far. In addition, guidelines for non-pharmacologic evidence-based treatment were reported in Canada, North America. By synthesizing the newly reported foreign guidelines for treatment and review articles, the aim of this study is to investigate the non-pharmacologic therapies used for treatment of tic disorder or Tourette's disorder.
Canada ; North America ; Prognosis ; Tic Disorders ; Tics* ; Tourette Syndrome*

OBJECTIVES: The purpose of this study was to examine the association of exposures to heavy metals with positive diagnosis for attention-deficit hyperactivity disorder (ADHD) and Tourette's syndrome (TS). METHODS: Study participants included 27 children diagnosed with ADHD (9.9+/-2.9 years of age), 21 diagnosed with Tourette's disorder (10.7+/-2.2 years of age), and 45 normal control children (9.6+/-0.5 years of age). A Perkin-Elmer mass spectrometer was used to measure the concentrations of 5 heavy metals (Pb, Cd, U, Be, Hg) in hair samples obtained from each participant. Each heavy metal concentration was compared among the groups by use of a Kruskal-Wallis test. RESULTS: The levels of lead (p=.006) and cadmium (p=.037) observed in the hair of children diagnosed with ADHD were significantly higher than those found in the control subjects. There were no significant differences observed for heavy metal levels when comparing TS and control subjects. CONCLUSION: We confirmed that lead exposure is a risk factor for ADHD. We also identified that cadmium may be a new candidate risk factor for manifestation of ADHD. We did not find an association between heavy metals and manifestation of TS.
Cadmium ; Child ; Hair ; Humans ; Metals, Heavy ; Risk Factors ; Tourette Syndrome

Trichoptilosis is a longitudinal splitting or fraying of the distal end of the hair caused by cumulative physical and/or chemical effects on the hair shaft. We present three cases of trichoptilosis patients complaining of alopecia, two cases with the scalp hairs and one case with the pubic hairs. One of the two scalp hair cases showed the hair shaft disorder as a part of a Tourette's syndrome and the other case was caused by scalp pruritus. The patient with pubic hair involvement showed hypochondriasis on his genital area. The cases were thought to be a good example showing the stereotypic change of the hair shaft in various different underlying diseases of the affected patients.
Alopecia ; Hair ; Humans ; Hypochondriasis ; Pruritus ; Scalp ; Tourette Syndrome

Professor 's experience in treatment of Tourette syndrome with 's scalp acupuncture were introduced. Professor believes that this disease is in category of tremor in TCM. Pathogenic wind is the key in its pathogenesis and liver, spleen and kidney are closely related. Hence, the treatment focuses on eliminating pathogenic wind and regulating the function of liver, spleen and kidney. The cerebrum is the regulation center in human body. The abnormal somatic function can be adjusted by acupuncture at the scalp area where the cerebral cortical function is projected. 's scalp acupuncture is suitable in treatment of Tourette syndrome. Such scalp acupuncture was introduced in this paper with the typical case reported so as to provide a new approach to clinical treatment.
Acupuncture Therapy ; Humans ; Scalp ; Spleen ; Tourette Syndrome ; therapy

To introduce the clinical experience of professor SUN Shen-tian in treatment of Tourette's syndrome (TS) with acupuncture. TS is a psychosomatic disease and the core pathogenesis refers to blood deficiency producing internal wind. The disease is located in the heart and liver. Acupoints are selected according to the functional orientation of the cerebral cortex. The extrapyramidal system area is preferred for tic disorder, and the emotional area is for behavioral disorder. The treatment focuses on regulating the mind by multiple methods, including manual needling technique used the transcranial repeated acupuncture, and regulating the mind by taking multiple acupoints, Baihui (GV 20), Neiguan (PC 6), Shenmen (HT 7) and Dazhong (KI 4) are stimulated. For abdominal twitching and mental symptoms of TS children, the first and third abdominal areas are selected. The target symptoms (biao) are treated specially by local acupoints, the combination of the starting and ending acupoints of the affected meridian, or the acupoints of the meridians with same name. The modified chaihu longgu muli decoction and siwu decoction are prescribed to sooth liver, nourish blood and soothe wind. In association with the characteristics and target symptoms of TS, the sequential therapy is used with filiform needling, intradermal needling, Chinese herbal medication and psychotherapy.
Child ; Humans ; Tourette Syndrome ; Acupuncture Therapy ; Meridians ; Liver ; Psychotherapy

Child ; Humans ; Sleep Wake Disorders ; diagnosis ; etiology ; Tourette Syndrome ; complications

Tic disorders (TD) are a group of neurodevelopmental disorders that are characterized by motor and/or vocal tics in children and adolescents. The etiology and pathogenesis of TD remain unclear, and it is believed to be caused by a combination of genetic, biological, psychological, and environmental factors. The major treatment for TD includes psychoeducation, behavioral intervention, and drug treatment. To further explore the management of TD, this article reviews the research advances in psychoeducation and behavioral intervention for patients with TD.
Adolescent ; Behavior Therapy ; Child ; Humans ; Tic Disorders ; Tourette Syndrome

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndromes(TS). In this case, 14 years old boys developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.
Adolescent ; Anxiety, Separation ; Haloperidol* ; Humans ; Imipramine ; Tics ; Tourette Syndrome*

The data on 24 Korean patient with Gilles de la Tourette's syndrome are described. Main symptoms and other clinical data and EEG findings were generally consistent with those on Caucasian and other Asian patients reported by many authors and reviewers. The effectiveness of haloperidol treatment was also good. These data are thought to suggest organic etiology of this syndrome, but emotional components should not be neglected in understanding and helping patients with varied symptoms other than tic movements.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Haloperidol/therapeutic use ; Human ; Male ; Tourette Syndrome/therapy*