Case Blog - International Journal of Clinical & Medical Images (2015) Volume 2, Issue 8
Author(s): Rajarshi Sannigrahi, Ajay Manickam*, Shaswati Sengupta, Jayanta saha, SK Basu an
Introduction Tourette syndrome is an inherited neuropsychiatric disorder with onset in childhood; it is characterized by multiple motor tics and at least one vocal tic. The occurrence of tics wax and wane with time can be suppressed voluntarily and are frequently preceded by a premonitory urge. Tourette is defined as a part of spectrum of tic disorders which include provisional, transient or persistent tics. The prevalence of tourrete is 0.4% to 3.8% among children between 5 to 18 years . The tourette syndrome can be associated with use of obscene words and derogatory remarks but this is present in only a few cases . Eye blinking, coughing, throat clearing, sniffing and facial movements are the common type of tics. Tourrete does not affect intelligence or life expectancy. To urrete is often associated with comorbid condition such as attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder(OCD). These conditions often cause more functional impairment than the tics.
Case Study 6 year old female patient presented in the ENT opd with recurrent sore throat. On examination bilateral tonsillitis was seen. During examination frequent blinking of eyes, grimacing, frowning and frequent protrusion of tongue was observed. The mother gave history of increased irritability, reduced sleep and appetite and frequent use of obsene words in public places for last 2 years. The family members ignored these symptoms. The patient was referred to psychiatry department. Urine drug analysis, serum cerulospasmin, complete heamogram, sugar, urea, creatinine and liver function test was within normal limits. The child was diagnosed to be suffering tourrete syndrome. The patient was offered psychobehavioral therapy and education and reassurance to the family members. The patient was also prescribed tab. fluoxetine (200mg) ½ tab daily. The patient received this treatment for 6 months and showed significant improvement. Bilateral tonsillectomy was done 1 year later.