Persistent (Chronic) Motor or Vocal Tic Disorder Essay

Posted: November 30th, 2022

Persistent (Chronic) Motor or Vocal Tic Disorder Essay

Discussion: Parent Guide Disorder: Persistent (Chronic) Motor or Vocal Tic Disorder Learning disorders and motor disorders can be difficult for parents to understand. They often have many questions that go unanswered and can create considerable misunderstanding. This misunderstanding can damage the child/parent relationship. The PMHNP can answer questions and provide guidance for the family in order to help reduce the uncertainty of the disorders. For the Discussion, you will work with your group again to develop a Parent Guide for your assigned disorder. Learning Objectives Students will: Persistent (Chronic) Motor or Vocal Tic Disorder Essay. •Analyze signs and symptoms of learning and motor disorders in childhood •Analyze pathophysiology of learning and motor disorders in childhood •Analyze diagnosis and treatment methods for learning and motor disorders in childhood •Evaluate Parent Guides To Prepare for this Discussion: •Your Instructor will assign you to a group and a disorder by Day 1 of Week 2. •Review the resources concerning your assigned disorder. •Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the Accessing Group Discussions instructions below. Using evidence-based research, design and develop a Parent Guide for your assigned disorder including: •Signs and symptoms •Pathophysiology •How the disorder is diagnosed •Treatment options Provide a minimum of three academic references. Persistent (Chronic) Motor or Vocal Tic Disorder Essay

PARENTS’ GUIDE

Tourette Syndrome (persistent motor tic disorder)

Introduction

• Tourettesyndrome is a psychological condition that is manifested in the central nervous system.
• It is characterized by sudden, recurrent, persistent, rapid and chronic movements and sounds in children.
• While tics are a normal occurrence in children, they are typically transient and would clear within one year while those with the disorder would report tics for more than one year.
• It presents as unconsciously blinking, throat clearing or blurting random words persistently without meaning to do so.
• Although the syndrome is not common, it is reported in about 100,000 USA residents, with greater incidence reported among males when compared to their female counterparts.
• The condition would typically present at an early age (usually among children) but clears and becomes less common as they grow older. Persistent (Chronic) Motor or Vocal Tic Disorder Essay
• The specific cause of the syndrome is yet unknown.
• However, researcher indicates that there is a possible link between the syndrome and abnormal development of the basal ganglia in the brain since it is responsible for controlling all motor and vocal movements in the body (Sadock, B., Sadock, V. & Ruiz, 2014).

Signs and Symptoms

• Tourette syndrome presents as persistent and uncontrollable movements of the body.
• It is reported among children who are younger than eighteen years of age, with the tics occurring for more than one year.
• These movements are referred to as tics and can occur either in the vocal cords or motor cells to present as either vocal tics or motor tics.
• The vocal tics involve the vocal chords to result in persistently swearing, shouting, sniffing, coughing, grunting, clearing the throat, barking and yelping.
• The motor tics involve the body making small muscle movements without conscious control to include twitching the mouth, shrugging the shoulders, facial grimacing, biting the lips, blinking the eyes, shrugging the shoulders,blinking, making a face, and jerking the arm, leg or head.
• It is important to note that all movements associated with the syndrome will involve chronic and uncontrolled contractions and relaxations of the body muscles.
• Another notable point is that the symptoms (tics) can either worsen or improve irrespective of whether the patient is subjected to treatment (Sadock, B., Sadock, V. & Ruiz, 2014). Persistent (Chronic) Motor or Vocal Tic Disorder Essay

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Pathophysiology

• The specific cause of Tourettesyndrome is unknown, thus making it difficult to determine its precise pathophysiology.
• However, it is postulated that the syndrome is caused by abnormal development of the basal ganglia in the brain.
• • As a result, the syndrome’s pathophysiology is postulated that it stems from synaptic neurotransmission noted by abnormality of the basal ganglia’s inferior prefrontal cortex and caudate nucleus.
  • In addition, it is postulated that the syndrome’s pathophysiology has links with dis-inhibition of the cortico-striatal-thalamic-cortical loops.
  • These postulations are supported by neuroimaging studies, showing that persons suffering from Tourette syndrome would typically have multifocal activation of the brain regions controlling sensorimotor, language and paralimbic activities when a tic incident occurs.
  • Other neuroimaging studies have identified the specific brain regions that are affected to include claustrum, superior temporal gyrus, insula, primary motor cortex, broca area, inferior periatal cortex, caudate nucleus, putamen, anterior cingulated cortex, lateral and medial premotor cortices, and dorsolateral-rostral prefrontal cortex(Sadock, B., Sadock, V. & Ruiz, 2014). Persistent (Chronic) Motor or Vocal Tic Disorder Essay

  Diagnosis

  • There are no standard diagnostic protocols for the diagnosis of Tourette syndrome.
  • Nonetheless, the most common diagnostic approach involves first identifying the present of persistent uncontrollable tics that would then be correlated with corresponding multifocal activation of the brain regions controlling sensorimotor, language and paralimbic activities.

  Diagnosis also evaluates how long the tics have been experienced, since cases of tics occurring for more than one year is a strong indicator for the syndrome(Martino &Leckman, 2013).Treatment Options

  • There is no known cure for Tourette syndrome with less attention on developing a cure since the tics would occur less frequently as the patient advances in age until eventually no more tics occur.
  • Nevertheless, the syndrome can be managed to ensure that the tics halt or occur less frequently.
  • This means that treating the disorder targets the symptoms presented as the tics.
  • Also, the disorder is chronic, and as such, treatment targets long-terms control of the symptoms rather than offering a speedy solution.
  • Managing the syndrome involved adopting either one of two treatment approaches.
  • The first treatment approach involves prescribing medication (neuroleptics) that interferes with the brain chemistry to suppress the multifocal activation of the brain regions controlling sensorimotor, language and paralimbic activities so that the tics either stop or occur less frequently. Persistent (Chronic) Motor or Vocal Tic Disorder Essay
  • The medication work by obstructing the dopamine neurotransmitters in the brain or depleting dopamine.
  • Examples of neuroleptics used to control Tourette syndrome include tetrabenazine, risperidone, pimozide, haloperidol, and fluphenazine.
  • It should be noted that medication is not recommended since it interferes with the brain chemistry and is accompanied by other undesirable side effects(Singer et al., 2010).
• • The second treatment approach involves subjecting the patient to behavioral therapy that includes elements of exposure and response prevention as well as habit reversal training.
  • Exposure and response training identifies the environmental factors that trigger the tics to include feelings, scents, scenes, individuals and climates.
  • The patient is then guided on how to dissociate the environmental factor from the tic so that it no longer acts as a trigger.
  • Also, the training presents a less noticeable response to the trigger to compete with the tic so that the patient is conditioned not to present the tic when the trigger occurs.
  • For instance, if the patient snaps his/her fingers (tic) in response to a specific scent (trigger) then he/she may be conditioned to exhale as an alternative response so that the tic occurrence becomes less frequent.
  • Habit reversal training guides the patient on how to gain conscious then unconscious control over the tic urges so that even if a trigger presents, the patient would no longer be compelled to experience a tic(Martino &Leckman, 2013).
  For Additional Information, visit:
  • https://www.webmd.com/brain/tourettes-syndrome#1
  • https://emedicine.medscape.com/article/289457-overview
  • https://www.nhs.uk/conditions/tourettes-syndrome/
  • https://www.tourette.org/about-tourette/overview/what-is-tourette/

• https://www.aafp.org/afp/2008/0301/p651.html
• https://www.uptodate.com/contents/tourette-syndrome

References

• Martino, D. &Leckman, J. (ed.) (2013). Tourette syndrome. New York, NY: Oxford University Press.
• Sadock, B., Sadock, V. & Ruiz, P. (2014). Kaplan &Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry (11^th). Philadelphia, PA: Wolters Kluwer.
• Singer, H., Jankovic, J. Mink, J. & Gilbert, D. (2010). Movement disorders in childhood. Philadellphia, PA: Saunders/Elsevier. Persistent (Chronic) Motor or Vocal Tic Disorder Essay