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Complications of Tourette’s syndrome and its treatment.

Complications of Tourette’s syndrome and its treatment.

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People with Tourette’s syndrome experience uncontrollable abrupt movements or sounds known as tics. This condition affects the nerve system. For instance, a person with Tourette’s syndrome might repeatedly blink or clear their throat. Some folks might say something out of the blue.

The most frequent forms of tics involve:

  • blinking
  • sniffing
  • grunting
  • throat clearing
  • grimacing
  • shoulder movements
  • head movements

Tics can be controlled by treatments, although some people don’t require any unless their symptoms are extremely bothersome.

A full-blown case of Tourette’s syndrome affects about 100,000 Americans, while more people have a milder variant of the condition. More boys than girls are affected, and it frequently begins in childhood. With age, symptoms frequently improve in youngsters. They disappear entirely for some people.

Different types of tics

Tics come in two types: verbal and motor.

Muscle Tics

Body motions are known as motor tics. Blinking, shrugging the shoulders, or jerking an arm are a few examples of motor tics.

Voice Ticks

The sounds a person creates with their voice are called vocal tics. Vocal tics include things like humming, throat clearing, and screaming out a word or phrase.

Tics can be simple or complex:

Simple Tics

Simple tics only affect a few body areas. This type of tics include sniffing or squinting the eyes.

Complex Tics

Complex tics frequently affect several separate body areas and may follow a pattern. A sophisticated tic might involve bobbing the head while jerking one arm, followed by a jump.

Symptoms of Tourette’s syndrome

Tics are the predominant symptom. Some are undetectable because they are so light. Others are visible and frequently occur. They can get worse during stress, excitement, or when one is ill or exhausted. The most serious ones might be embarrassing and have an impact on your career or social life.

Tics come in two varieties:

Movement is a part of motor tics. They consist of:

  • head or arm jerking
  • Blinking
  • Posing a grin
  • Mouth fluttering
  • shrugging shoulders

Vocal tics consist of:

Tics can be straightforward or complex. Simple tics, such as eye blinking or facial expressions, only affect one or a small number of bodily components. A difficult one includes using numerous bodily parts or speaking. Examples include jumping and cursing.

You might experience a tingling or tense feeling just before a motor tic. The sensation disappears as a result of movement. You might be able to temporarily suppress your tics, but it’s unlikely that you will be able to do so permanently.

About half of persons with Tourette’s also exhibit symptoms of attention deficit hyperactivity disorder, though doctors aren’t sure why (ADHD). You could struggle to focus, maintain your composure, and complete chores.

Additionally, tourette’s can lead to issues with:

  • Anxiety
  • learning disorders like dyslexia
  • Obsessive-compulsive disorder (OCD) is characterised by uncontrollable thoughts and actions, such as repeatedly washing your hands.

Causes of Tourette syndrome

An extremely complex syndrome is twitching. It involves changes to the electrical pathways connecting various sections of your brain that are aberrant. The area of your brain that contributes to controlling motor movements, the basal ganglia, may have an anomaly if you have Tourette syndrome.

Your brain’s chemical messengers of nerve impulses may also be at play. Neurotransmitters are the name for these substances.

Several neurotransmitters are:

  • dopamine
  • serotonin
  • norepinephrine

Remember that there is no test to identify Tourette syndrome. Neurotransmitter blood levels and brain imaging both seem normal.

There is no cure for Tourette syndrome at this time, and there is no recognised cause. It may be caused by a genetic variation that is inherited, according to researchers. The precise genes that are directly connected to Tourette syndrome are being sought after.

Family groupings have been recognised, nevertheless. These clusters suggest to researchers that heredity may contribute to the development of Tourette’s in some individuals.

How is Tourette syndrome treated?

You might not need therapy if your tics are not severe and you have a milder form of Tourette syndrome. There are numerous treatments available if your tics are severe or are making you think about harming yourself. If your tics get more severe as you get older, a healthcare practitioner may also suggest treatments.

Therapy

A medical expert might advise behavioural therapy or psychotherapy for you. Individual counselling with a qualified mental health expert is involved in this.

In behavioural therapy, there are:

  • awareness instruction
  • competition reaction instruction
  • Cognitive behavioural therapy for tic prevention

Similar treatments may also be beneficial for:

  • ADHD
  • OCD
  • anxiety

Throughout psychotherapy sessions, your therapist may also employ the following techniques:

  • relaxation strategies
  • guided introspection
  • activities for deep breathing
  • hypnosis

You might benefit from group treatment. With others of the same age who also have Tourette syndrome, you will receive counselling.

Medications

Tourette syndrome cannot be treated with medication. To assist you control your symptoms, your doctor may perhaps suggest one or more of the following medications:

Risperidone (Risperdal), haloperidol (Haldol), aripiprazole (Abilify), or other neuroleptic medications.

  • Onabotulinum toxin A (Botox).
  • Methylphenidate (Ritalin).
  • Clonidine.
  • Topiramate (Topamax).
  • Cannabis-based medications.

Neurological treatments

Another method of treatment for those with severe tics is deep brain stimulation. The efficacy of this type of therapy for those who have Tourette syndrome is still being studied.

Your doctor may implant a battery-operated device in your head to stimulate the areas of your brain that regulate movement as part of deep brain stimulation. As an alternative, they might put electrical wires inside your brain to stimulate certain areas with electricity.

People with tics who had been thought to be very difficult to treat have benefited from this approach. To find out about the possible risks and advantages for you and to determine whether this treatment might be effective for your healthcare requirements, you should speak with a healthcare expert.

Long-term outlook

You might discover, like many others with Tourette syndrome, that your tics subside in your late teens and early 20s. In adulthood, your symptoms might even abruptly vanish altogether.

Nevertheless, even if your Tourette symptoms lessen as you age, you can still experience linked illnesses including depression, panic attacks, and anxiety and require therapy for them. It’s critical to keep in mind that Tourette syndrome is a medical illness unrelated to intelligence or lifespan.

You can control Tourette symptoms with advancements in therapy, your healthcare team, and access to tools and support, which can help you have a full life.

REFERENCES:

  • https://www.healthline.com/health/gilles-de-la-tourette-syndrome
  • https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/symptoms-causes/syc-20350465
  • https://www.cdc.gov/ncbddd/tourette/facts.html
  • https://www.webmd.com/brain/tourettes-syndrome
  • https://my.clevelandclinic.org/health/diseases/5554-tourette-syndrome

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Important note on Parkinson’s disease you need to know.

Important note on Parkinson’s disease you need to know.

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Parkinson’s disease is a neurological condition that worsens over time. Movement issues are one of the earliest symptoms. Dopamine is a chemical that exists in the brain and is responsible for smooth and coordinated motions of the body’s muscles. The “substantia nigra” is a region of the brain where dopamine is made.

The substantia nigra cells begin to deteriorate in Parkinson’s disease. Dopamine levels drop as a result of this. Parkinson’s disease symptoms begin to show up when they have decreased by 60 to 80%.

Parkinson’s disease stages

Parkinson’s is a progressive illness, which means that over time, the condition’s symptoms usually get worse.

The Hoehn and Yahr scale is frequently used by doctors to categorise its stages. This scale categorises symptoms into five phases and aids medical practitioners in determining the severity of disease symptoms and signs.

Stage 1

Stage 1 is the mildest type is Parkinson’s. In fact, it’s so mild that you could not even notice any symptoms. Your regular activities and chores might not yet be affected by them.

Even if you do experience symptoms, they might just affect one side of your body.

Stage 2

It may take months or even years for stage 1 to move into stage 2. The experiences of each person will vary. You might feel symptoms at this stage, which is moderate such as:

Stiffness in your muscles can make regular tasks more difficult and take longer to complete. However, you probably won’t have any balance issues at this point.

The body’s two sides may experience the same symptoms. Posture, movement, and facial expression modifications may be more obvious.

Stage 3

The symptoms change course at this midpoint. You probably won’t develop any new symptoms, but they might become more obvious. They might also obstruct all of your daily activities.

Activities move more slowly as a result of the noticeable slower movements. Falls can grow more frequent as balance problems become more serious. However, people with Parkinson’s disease in stage 3 can typically keep their independence and carry out daily tasks without much help.

Stage 4

There are substantial modifications as the stages 3 and 4 proceed. Without a walker or other aid, it will be quite difficult for you to stand at this point.

Significantly slower reactions and muscle motions are also observed. It might be risky and unsafe to live alone.

Stage 5

In this most advanced stage, constant help is required due to the intense symptoms. Standing will be challenging, if not impossible. Most likely, a wheelchair will be needed.

Parkinson’s patients may also have disorientation, delusions, and hallucinations at this stage. The disease’s consequences can start developing in its latter stages.

Symptoms of Parkinson’s disease

Some of the early signs of Parkinson’s can show up years before there are any movement issues. These initial indications include:

  • reduced capacity to smell (anosmia)
  • constipation
  • tiny, squished handwriting
  • voice variations
  • hunched position

The four most prevalent motor issues include:

  • tremor (shaking that occurs at rest)
  • sluggish motions
  • rigidity in the arms, legs, and trunk
  • difficulties with balance and a propensity to tumble

Additional signs include:

  • blank look on the face
  • a propensity to become trapped while walking
  • low-pitched, muted speech
  • reduced swallowing and blinking
  • inclination to reverse direction
  • shortened arm walking while swinging
  • Parkinsonian gait, or the propensity to walk with shuffled steps

Additional signs and symptoms could be:

  • Seborrheic dermatitis is the condition when the skin develops flaky white or yellow scales on greasy areas.
  • greater likelihood of developing the deadly skin disease melanoma
  • vivid dreams, chatting, and movement while sleeping are all signs of disturbed sleep.
  • depression
  • anxiety
  • hallucinations
  • psychosis
  • issues with focus and memory
  • visual-spatial interactions are challenging

Parkinson’s disease’s early warning signals could go unnoticed. With these warning signals, your body may try to warn you of the movement issue years before any movement difficulties appear.

Causes of Parkinson’s disease

Parkinson’s disease is a neurological condition brought on by alterations in the brain. Although the exact reason why it occurs is unknown, scientists have found some varieties that do.

Low dopamine levels

Parkinson’s disease symptoms are mostly brought on by low or declining levels of the neurotransmitter dopamine. It occurs when brain cells that make dopamine die.

The area of the brain that regulates movement and coordination receives information from dopamine. Therefore, it may be more difficult for people to control their movement when dopamine levels are low.

The severity of the symptoms gradually worsens as dopamine levels continue to drop.

low levels of norepinephrine

Damage to the nerve terminals that create another neurotransmitter, norepinephrine, which supports blood circulation and other natural bodily activities, may also be a component of Parkinson’s disease.

Parkinson’s disease patients with low norepinephrine levels may have both motor and nonmotor symptoms like:

  • rigidity and stiffness
  • physical unsteadiness
  • tremor
  • anxiety
  • having trouble focusing
  • dementia
  • depression

This may help to explain why orthostatic hypotension frequently occurs in persons with Parkinson’s disease. When someone stands up, their blood pressure fluctuations, which can cause dizziness and a chance of falling, is referred to as this.

The Lewy body

The brain of a person with Parkinson’s disease may have Lewy bodies, or clusters of the protein alpha-synuclein. Changes in movement, thinking, behaviour, and mood can result from the buildup of Lewy bodies, which can also result in nerve cell death. Dementia may also result from it.

Lewy body dementia is not the same as Parkinson’s disease, although because the symptoms are similar, some people may have both.

Genetic factors

Although mutations in numerous genes have been found to be associated with Parkinson’s disease, experts do not believe this to be a hereditary ailment.

Only 10% of cases, particularly in those with early-onset disease, seem to be genetic in nature.

Autoimmune factors

According to a 2017 study, there may be a hereditary connection between inflammatory diseases like rheumatoid arthritis and Parkinson’s disease.

In 2018, Taiwanese health data were examined by researchers who discovered a 1.37-fold increased risk of Parkinson’s disease in patients with autoimmune rheumatic disorders.

Risk factors for parkinson’s disease

Parkinson’s disease risk may be increased by a number of environmental variables.

These consist of:

  • Past traumatic brain injury: For instance, head traumas sustained while playing contact sports may raise the likelihood of the illness.
  • Exposure to toxins: These include metals, pesticides, solvents, and other contaminants.
  • Males are 50% more likely than females to have the illness, while a 2016 study found that the risk for females may rise with age.
  • Age: The illness frequently manifests around the age of 60.
  • Some pharmaceuticals: Some drugs can cause Parkinsonism, a condition in which a person exhibits tremors and other symptoms but does not have Parkinson’s disease.

Symptoms typically start to show up around the age of 60. However, early-onset Parkinson’s, which manifests before the age of 50, affects 5–10% of those who have the condition.

Statistics in the past have indicated that Black Americans are less likely than people of other ethnicities to have Parkinson’s disease.

The lack of knowledge about how the disease can affect Black people and a higher likelihood of misdiagnosis as a result of unequal access to healthcare, according to experts, may be to blame for this.

REFERENCES:

  • https://www.healthline.com/health/parkinsons
  • https://www.medicalnewstoday.com/articles/323409
  • https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
  • https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview
  • https://www.nia.nih.gov/health/parkinsons-disease

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