Tiques e síndrome de Gilles de la Tourette

Mattos, James Pitágoras de; Rosso, Ana Lúcia Zuma de

doi:10.1590/S0004-282X1995000100022

Resumos

Os autores revisam a literatura a propósito dos tiques e da síndrome de Gilles de la Tourette, abordando os aspectos históricos, etiopatogênicos, neuropatológicos, semiológicos, clínicos e terapêuticos.

tiques; síndrome de Gilles de la Tourette; tiques motores; tiques vocais

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 188S, 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; Gilles de la Tourette syndrome; motor tics; vocal tics

Tiques e síndrome de Gilles de la Tourette

Ties and Gilles de la Tourette syndrome

James Pitágoras de Mattos^I; Ana Lúcia Zuma de Rosso^II

^IProfessor Adjunto de Neurologia da Universidade Federal do Rio de Janeiro (UFRJ), Chefe do Setor de Doenças Extrapiramidais do Hospital Universitário Clementino Fraga Filho (HUCFF) -UFRJ

^IIMédica Neurologista do HUCFF-UFRJ. Serviço de Neurologia do HUCFF-UFRJ (Chefia: Prof. Dr. Sérgio Novis)

RESUMO

Os autores revisam a literatura a propósito dos tiques e da síndrome de Gilles de la Tourette, abordando os aspectos históricos, etiopatogênicos, neuropatológicos, semiológicos, clínicos e terapêuticos.

Palavras-chave: tiques, síndrome de Gilles de la Tourette, tiques motores, tiques vocais.

SUMMARY

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 188S, 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.

Key words:tics, Gilles de la Tourette syndrome, motor tics, vocal tics.

Texto completo disponível apenas em PDF.

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Aceite: 30-setembro-1994.

Conferência proferida na Jornada "Doenças dos Gânglios da Base", realizada em São José do Rio Preto (SP) no mês de maio de 1994

1. Adams RD, Victor M. Principles of neurology. Ed 5. New York: McGraw-Hill, 1993, p 95-98 (Tremor, myoclonus, spasms and tics).
2. Balthasar K. Über das anatomische Substrat der generalisierten Tic-Krankheit (maladie des tics, Gilles de la Tourette): Entwicklungshemmung des Corpus striatum. Arch Psychiat (Berlin) 19S7, 195:531-549.
3. Chase TN, Geoffrey V, Gillespie M, Burrows GH. Structural and functional studies of Gilles de la Tourette syndrome. Rev Neurol (Paris) 1986, 142: 851-855.
4. Costa AL, Badim A. Síndrome de Gilles de la Tourette. In Coloquios Neurológicos. Rio de Janeiro Interciência, 1991, p 280-282.
5. Dordain G. Le concept de tic dans l'histoire des mouvements anormaux. Rev Neurol (Paris) 1986, 142:803-807.
6. Dugas M. La maladie des tics: d'Itard aux neuroleptiques. Rev Neurol (Paris) 1986, 142:817-823.
7. Eldridge R, Denckla MB. Gilles de la Tourette syndrome: etiologic considerations. Rev Neurol (Paris) 1986, 142:833-839.
8. Gilles de la Tourette. Étude sur une affection nerveuse caractérisée par l'incoordination motrice accompagnée d'écholalie et de coprolalia Arch Neurol 1885, 9:19-42, 158-200.
9. Gonce M, Dugas M. Tics et syndrome de Gilles de la Tourette. Encycl Med Chir (Paris), Neurologie 12-1986, 17059 C¹⁰
10. Hemming M, Yellowlees PM. Effective treatment of Tourette's syndrome with marijuana. J Psychopharmacol 1993, 7:389-391.
11. Jankovic J. The neurology of tics. In Marsden CD, Fahn S (eds). Movement disorders 2 London: Butterworth 1987, p 383-405.
12. Kurlan R, Majumdar L, Deeley C, Mudholkar GS, Plumb S, Como PG. A controlled trial of propoxyphene and naltrexone in patients with Tourette's syndrome. Ann Neurol 1991, 30:19-23.
13. Lees AJ. Georges Gilles de la Tourette: the man and his time. Rev Neurol (Paris) 1986, 142:808-816.
14. Price RA, Kidd KK, Cohen DJ, Pauls DL, Leckman JF. A twin study of Tourette syndrome. Arch of Gen Psychiatry 1985, 42:815-820.
15. Seignot JM. Un cas de maladie des tics de Gilles de la Tourette guéri par le R-1625. Ann Médicopsychol 1961, 119:578-579.
16. Shapiro E, Shapiro A. Semiology, nosology and criteria for tic disorders. Rev Neurol (Paris) 1986, 142:824-832.
17. Singer HS, Hahn I-H, Moran TH. Abnormalities of dopaminergic markers in postmortem striatal specimens from patients in Tourette syndrome. Ann Neurol 1990, 28:441.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Mar 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Adams RD, Victor M. Principles of neurology. Ed 5. New York: McGraw-Hill, 1993, p 95-98 (Tremor, myoclonus, spasms and tics).

[2] 2. Balthasar K. Über das anatomische Substrat der generalisierten Tic-Krankheit (maladie des tics, Gilles de la Tourette): Entwicklungshemmung des Corpus striatum. Arch Psychiat (Berlin) 19S7, 195:531-549.

[3] 3. Chase TN, Geoffrey V, Gillespie M, Burrows GH. Structural and functional studies of Gilles de la Tourette syndrome. Rev Neurol (Paris) 1986, 142: 851-855.

[4] 4. Costa AL, Badim A. Síndrome de Gilles de la Tourette. In Coloquios Neurológicos. Rio de Janeiro Interciência, 1991, p 280-282.

[5] 5. Dordain G. Le concept de tic dans l'histoire des mouvements anormaux. Rev Neurol (Paris) 1986, 142:803-807.

[6] 6. Dugas M. La maladie des tics: d'Itard aux neuroleptiques. Rev Neurol (Paris) 1986, 142:817-823.

[7] 7. Eldridge R, Denckla MB. Gilles de la Tourette syndrome: etiologic considerations. Rev Neurol (Paris) 1986, 142:833-839.

[8] 8. Gilles de la Tourette. Étude sur une affection nerveuse caractérisée par l'incoordination motrice accompagnée d'écholalie et de coprolalia Arch Neurol 1885, 9:19-42, 158-200.

[9] 9. Gonce M, Dugas M. Tics et syndrome de Gilles de la Tourette. Encycl Med Chir (Paris), Neurologie 12-1986, 17059 C¹⁰

[10] 10. Hemming M, Yellowlees PM. Effective treatment of Tourette's syndrome with marijuana. J Psychopharmacol 1993, 7:389-391.

[11] 11. Jankovic J. The neurology of tics. In Marsden CD, Fahn S (eds). Movement disorders 2 London: Butterworth 1987, p 383-405.

[12] 12. Kurlan R, Majumdar L, Deeley C, Mudholkar GS, Plumb S, Como PG. A controlled trial of propoxyphene and naltrexone in patients with Tourette's syndrome. Ann Neurol 1991, 30:19-23.

[13] 13. Lees AJ. Georges Gilles de la Tourette: the man and his time. Rev Neurol (Paris) 1986, 142:808-816.

[14] 14. Price RA, Kidd KK, Cohen DJ, Pauls DL, Leckman JF. A twin study of Tourette syndrome. Arch of Gen Psychiatry 1985, 42:815-820.

[15] 15. Seignot JM. Un cas de maladie des tics de Gilles de la Tourette guéri par le R-1625. Ann Médicopsychol 1961, 119:578-579.

[16] 16. Shapiro E, Shapiro A. Semiology, nosology and criteria for tic disorders. Rev Neurol (Paris) 1986, 142:824-832.

[17] 17. Singer HS, Hahn I-H, Moran TH. Abnormalities of dopaminergic markers in postmortem striatal specimens from patients in Tourette syndrome. Ann Neurol 1990, 28:441.

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Tiques e síndrome de Gilles de la Tourette

Ties and Gilles de la Tourette syndrome

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