Nervenheilkunde 2020; 39(05): 284-290
DOI: 10.1055/a-1094-9474
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Gilles-de-la-Tourette-Syndrom

Klinisches Spektrum und KomorbiditätenGilles de la Tourette Syndrome
Julius Hübl
1   Department of Neurology, Charité University Medicine Berlin
,
Christos Ganos
1   Department of Neurology, Charité University Medicine Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
05 May 2020 (online)

ZUSAMMENFASSUNG

Das Gilles-de-la-Tourette-Syndrom (GTS) zählt zu den häufigeren primären Tic-Störungen im klinischen Alltag. Die Diagnose basiert auf der Kombination motorischer und vokaler Tics mit Beginn im Kindes- oder Jugendalter und ist in den meisten Fällen mit hoher Sicherheit möglich. Selten sind Tics die einzigen Symptome bei GTS-Patienten. Bei der Mehrzahl bestehen weitere neuropsychiatrische Komorbiditäten wie ADHS, Zwangs- und affektive Störungen. Störungen aus dem Autismus-Spektrum sind ebenfalls häufig mit Tics assoziiert. Anzahl und Ausmaß der Komorbiditäten können hierbei mit der Intensität und Frequenz der Tics korrelieren und beeinflussen maßgeblich die Lebensqualität. Die Differenzialdiagnose von Tics umfasst zum einen weitere hyperkinetische Bewegungsstörungen wie Myoklonus und Chorea, zum anderen das Spektrum funktioneller Tic-ähnlicher Bewegungen. In dem vorliegenden Artikel beschreiben wir das klinische Spektrum des GTS mit typischen Komorbiditäten und klinische Anhaltspunkte in der Differenzialdiagnose von Tics.

ABSTRACT

Gilles de la Tourette Syndrome (GTS) is the prototypical primary tic disorder encountered in clinical practice. The diagnosis of GTS is based on the hallmark feature of motor and phonic tics, with onset in childhood or adolescence. Tics are rarely the only feature in patients with GTS, and indeed a wide spectrum of neuropsychiatric comorbidities is often present and ranges from attention-deficit hyperactivity disorder and obsessive-compulsive disorder to affective disorders. Autism spectrum disorders are also often associated with the presence of tic behaviors. Often, the number and severity of neuropsychiatric comorbidities may also correlate with tic severity and poor quality of life. The differential diagnosis of tics includes their distinction from other hyperkinesias, such as myoclonus or chorea, and most importantly the entity of functional tic-like movements. Here, we describe the essential clinical characteristics of the movement disorder of tics and their associations in GTS and provide a basic differential diagnostic guide on the clinical approach of tic behaviors.

 
  • Literatur

  • 1 Scharf JM. et al Population prevalence of Tourette syndrome: a systematic review and meta-analysis. Mov Disord 2015; 30 (02) 221-8
  • 2 Robertson MM, Eapen V, Cavanna AE. The international prevalence, epidemiology, and clinical phenomenology of Tourette syndrome: a cross-cultural perspective. J Psychosom Res 2009; 67 (06) 475-83
  • 3 Browne HA, Hansen SN. et al Familial clustering of tic disorders and obsessive-compulsive disorder. JAMA Psychiatry 2015; 72 (04) 359-66
  • 4 Marshall JW. The Neurological Theatre of Hysterioepilepsy, in Performing Neurology: The Dramaturgy of Dr Jean-Martin Charcot. Palgrave Macmillan US: New York; 2016: 127-136
  • 5 Ganos C, Munchau A, Bhatia KP. The Semiology of Tics, Tourette’s, and Their Associations. Mov Disord Clin Pract 2014; 1 (03) 145-153
  • 6 Paszek J, Pollok B, Biermann-Ruben K. et al Is it a tic? – Twenty seconds to make a diagnosis. Mov Disord 2010; 25 (08) 1106-8
  • 7 Ganos C, Bongert J, Asmuss L. et al The somatotopy of tic inhibition: Where and how much?. Mov Disord 2015; 30 (09) 1184-9
  • 8 Robertson MM. Tourette syndrome, associated conditions and the complexities of treatment. Brain 2000; 123 Pt 3 425-62
  • 9 Ganos C. et al The pathophysiology of echopraxia/echolalia: relevance to Gilles de la Tourette syndrome. Mov Disord 2012; 27 (10) 1222-9
  • 10 Finis J, Moczydlowski A, Pollok B. et al Echoes from childhood--imitation in Gilles de la Tourette Syndrome. Mov Disord 2012; 27 (04) 562-5
  • 11 Freeman RD, Zinner SH, Muller-Vahl KR. et al Coprophenomena in Tourette syndrome. Dev Med Child Neurol 2009; 51 (03) 218-27
  • 12 Sambrani T, Jakubovski E, Muller-Vahl KR. New Insights into Clinical Characteristics of Gilles de la Tourette Syndrome: Findings in 1032 Patients from a Single German Center. Front Neurosci 2016; 10: 415
  • 13 Mainka T, Balint B, Gövert F. et al The spectrum of involuntary vocalizations in humans: a video atlas. Mov Disord 2019; 34 (12) 1774-1791
  • 14 Ganos C. et al “I swear it is Tourette’s!”: On functional coprolalia and other tic-like vocalizations. Psychiatry Res 2016; 246: 821-826
  • 15 Ganos C, Muller-Vahl K, Bhatia KP. Blocking Phenomena in Gilles de la Tourette Syndrome. Mov Disord Clin Pract 2015; 2 (04) 438-439
  • 16 Pappert EJ. et al Objective assessments of longitudinal outcome in Gilles de la Tourette’s syndrome. Neurology 2003; 61 (07) 936-40
  • 17 Cox JH, Seri S, Cavanna AE. Sensory aspects of Tourette syndrome. Neurosci Biobehav Rev 2018; 88: 170-176
  • 18 Ganos C, Kahl U, Schunke O. et al Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?. J Neurol Neurosurg Psychiatry 2012; 83 (10) 975-8
  • 19 Cavanna AE, Black KJ, Hallett M. et al Neurobiology of the Premonitory Urge in Tourette’s Syndrome: Pathophysiology and Treatment Implications. J Neuropsychiatry Clin Neurosci 2017; 29 (02) 95-104
  • 20 Delorme C, Salvador A, Voon V. et al Illusion of agency in patients with Gilles de la Tourette Syndrome. Cortex 2016; 77: 132-140
  • 21 Koller WC, Biary NM. Volitional control of involuntary movements. Mov Disord 1989; 4 (02) 153-6
  • 22 Muller-Vahl KR, Riemann L, Bokemeyer S. Tourette patients’ misbelief of a tic rebound is due to overall difficulties in reliable tic rating. J Psychosom Res 2014; 76 (06) 472-6
  • 23 Rizzo R, Gulisano M, Cali PV. et al Long term clinical course of Tourette syndrome. Brain Dev 2012; 34 (08) 667-73
  • 24 Eapen V, Cavanna AE, Robertson MM. Comorbidities, Social Impact, and Quality of Life in Tourette Syndrome. Front Psychiatry 2016; 7: 97
  • 25 Hirschtritt ME, Lee PC, Pauls DL. et al Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry 2015; 72 (04) 325-33
  • 26 Mathews CA, Grados MA. Familiality of Tourette syndrome, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder: heritability analysis in a large sib-pair sample. J Am Acad Child Adolesc Psychiatry 2011; 50 (01) 46-54
  • 27 Frankel M, Cummings JL. et al Obsessions and compulsions in Gilles de la Tourette’s syndrome. Neurology 1986; 36 (03) 378-82
  • 28 Leckman JF. et al “Just right” perceptions associated with compulsive behavior in Tourette’s syndrome. Am J Psychiatry 1994; 151 (05) 675-80
  • 29 Freeman RD. Tourette Syndrome International Database C, Tic disorders and ADHD: answers from a world-wide clinical dataset on Tourette syndrome. Eur Child Adolesc Psychiatry 2007; 16 (Suppl. 01) 15-23
  • 30 Termine C, Luoni C, Fontolan S. et al Impact of co-morbid attention-deficit and hyperactivity disorder on cognitive function in male children with Tourette syndrome: A controlled study. Psychiatry Res 2016; 243: 263-7
  • 31 Mathews CA, Waller J, Glidden D. et al Self injurious behaviour in Tourette syndrome: correlates with impulsivity and impulse control. J Neurol Neurosurg Psychiatry 2004; 75 (08) 1149-55
  • 32 Robertson MM, Trimble MR, Lees AJ. Self-injurious behaviour and the Gilles de la Tourette syndrome: a clinical study and review of the literature. Psychol Med 1989; 19 (03) 611-25
  • 33 Chen K, Budman CL, Diego Herrera L. et al Prevalence and clinical correlates of explosive outbursts in Tourette syndrome. Psychiatry Res 2013; 205 (03) 269-75
  • 34 Burd L, Li Q, Kerbeshian J. et al Tourette syndrome and comorbid pervasive developmental disorders. J Child Neurol 2009; 24 (02) 170-5
  • 35 State MW. The genetics of child psychiatric disorders: focus on autism and Tourette syndrome. Neuron 2010; 68 (02) 254-69
  • 36 Clarke RA, Lee S, Eapen V. Pathogenetic model for Tourette syndrome delineates overlap with related neurodevelopmental disorders including Autism. Transl Psychiatry 2012; 2: e158
  • 37 Pringsheim T, Hammer T. Social behavior and comorbidity in children with tics. Pediatr Neurol 2013; 49 (06) 406-10
  • 38 Kahl U, Schunke O. et al Tic Phenomenology and Tic Awareness in Adults With Autism. Mov Disord Clin Pract 2015; 2 (03) 237-242
  • 39 Lim GY, Tam WW. et al Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Sci Rep 2018; 8 (01) 2861
  • 40 Rizzo R, Gulisano M. et al Gilles de la Tourette Syndrome, Depression, Depressive Illness, and Correlates in a Child and Adolescent Population. J Child Adolesc Psychopharmacol 2017; 27 (03) 243-249
  • 41 Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res 2009; 67 (06) 497-501
  • 42 Groth C. Tourette syndrome in a longitudinal perspective. Clinical course of tics and comorbidities, coexisting psychopathologies, phenotypes and predictors. Dan Med J 2018; 65: 4
  • 43 Lin H, Katsovich L, Ghebremichael M. et al Psychosocial stress predicts future symptom severities in children and adolescents with Tourette syndrome and/or obsessive-compulsive disorder. J Child Psychol Psychiatry 2007; 48 (02) 157-66
  • 44 Groth C, Debes NM, Skov L. Phenotype Development in Adolescents With Tourette Syndrome: A Large Clinical Longitudinal Study. J Child Neurol 2017; 32 (13) 1047-1057
  • 45 Abdo WF, van de Warrenburg BP, Burn DJ. et al The clinical approach to movement disorders. Nat Rev Neurol 2010; 6 (01) 29-37
  • 46 Mills S, Hedderly T. A guide to childhood motor stereotypies, tic disorders and the tourette spectrum for the primary care practitioner. Ulster Med J 2014; 83 (01) 22-30
  • 47 Bruno MK, Hallett M, Gwinn-Hardy K. et al Clinical evaluation of idiopathic paroxysmal kinesigenic dyskinesia: new diagnostic criteria. Neurology 2004; 63 (12) 2280-7
  • 48 Ganos C, Mencacci N, Gardiner A. et al Paroxysmal Kinesigenic Dyskinesia May Be Misdiagnosed in Co-occurring Gilles de la Tourette Syndrome. Mov Disord Clin Pract 2014; 1 (01) 84-86
  • 49 Kompoliti K. et al Hyperkinetic movement disorders misdiagnosed as tics in Gilles de la Tourette syndrome. Mov Disord 1998; 13 (03) 477-80
  • 50 Muller-Vahl KR, Krueger D. Does Tourette syndrome prevent tardive dyskinesia?. Mov Disord 2011; 26 (13) 2442-3
  • 51 Damasio J, Edwards MJ, Alonso-Canovas A. et al The clinical syndrome of primary tic disorder associated with dystonia: a large clinical series and a review of the literature. Mov Disord 2011; 26 (04) 679-84
  • 52 Erro R, Martino D, Ganos C. et al Adult-Onset Primary Dystonic Tics: A Different Entity?. Mov Disord Clin Pract 2014; 1 (01) 62-66
  • 53 Irani SR, Michell AW. et al Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol 2011; 69 (05) 892-900
  • 54 Ganos C, Martino D, Espay AJ. et al Tics and functional tic-like movements: can we tell them apart?. Neurology 2019; 93 (17) 750-758
  • 55 Demartini B, Ricciardi L, Parees I. et al A positive diagnosis of functional (psychogenic) tics. Eur J Neurol 2015; 22 (03) 527-e36
  • 56 Baizabal-Carvallo JF, Jankovic J. The clinical features of psychogenic movement disorders resembling tics. J Neurol Neurosurg Psychiatry 2014; 85 (05) 573-5
  • 57 Robinson S, Hedderly T. Novel Psychological Formulation and Treatment of “Tic Attacks” in Tourette Syndrome. Front Pediatr 2016; 4: 46
  • 58 Kurlan R, Deeley C, Como PG. Psychogenic movement disorder (pseudo-tics) in a patient with Tourette’s syndrome. J Neuropsychiatry Clin Neurosci 1992; 4 (03) 347-8
  • 59 Kutlubaev MA, Xu Y. et al Dual diagnosis of epilepsy and psychogenic nonepileptic seizures: Systematic review and meta-analysis of frequency, correlates, and outcomes. Epilepsy Behav 2018; 89: 70-78
  • 60 Nielsen G, Stone J, Matthews A. et al Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry 2015; 86 (10) 1113-9
  • 61 Ganos C, Muller-Vahl K. Cannabinoids in functional tic-like movements. Parkinsonism Relat Disord 2019; 60: 179-181
  • 62 Knight T, Steeves T, Day L. et al Prevalence of tic disorders: a systematic review and meta-analysis. Pediatr Neurol 2012; 47 (02) 77-90