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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.53 no.1 São Paulo Mar. 1995 

Tiques e síndrome de Gilles de la Tourette


Ties and Gilles de la Tourette syndrome



James Pitágoras de MattosI; Ana Lúcia Zuma de RossoII

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)




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.


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.



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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

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