Abstract
A series of 75 cases of Gilles de la Tourette syndrome (GTS) from Argentina, whose ages ranged from 6 to 55 with a mean of 20.02, were evaluated to compare findings with those reported for other countries. Mean age at onset was 7.44 years and mean overall duration of symptoms was 12.58 years; 6.7% of cases were mild, 49% moderate and 44.3% severe. Most frequent presenting motor tics were excessive blinking in 41 followed by head jerking in 16 and eye winking in six, while phonic tics included coprolalia in 28.0%, echolalia in 17.5% and palilalia in 10.8%. Abnormal perinatal events were reported in 40.5%, while positive family history for tics was present in 26.66%. Obsessive–compulsive behaviour was evident in 66% and attention deficit disorder in 16% of cases. Self-injurious behaviour comprised onychophagia in 28 patients, lip-biting in seven and self-slapping in eight cases. Almost half of our patients were initially interpreted as having a psychogenic disorder indicating that GTS in Argentina is most likely underdiagnosed. It may be concluded that the overall pattern of GTS is not dissimilar to that described for European, Asian and American populations, thus highlighting the previously recognized cross-cultural uniformity.
Highlights
Gilles de la Tourette syndrome (GTS) has long been recognized as a hereditary disorder featuring motor and phonic tics with early onset that wax and wane and change in nature over time. named after Georges Gilles de la Tourette in 1885, a previous case had already been described by Itard as early as 1825.Considered a rare neuropsychiatric disorder for decades, it was only in the last 30 years that GTS attracted the increasing attention of research workers who laid down criteria for its diagnosis
We evaluated prospectively 75 cases, presenting with chronic tics, seen consecutively in the outpatient clinic of the departments of neurology of the Hospital de Clinicas, Juan P
Dystonic tics were present in 29 patients and involved the cervical area in 18, orbicular oculi in three, hands in five and masticatory muscles in three, while sensory tics were reported in nine cases
Summary
Gilles de la Tourette syndrome (GTS) has long been recognized as a hereditary disorder featuring motor and phonic tics with early onset that wax and wane and change in nature over time. Considered a rare neuropsychiatric disorder for decades, it was only in the last 30 years that GTS attracted the increasing attention of research workers who laid down criteria for its diagnosis. The classic triad of multiple tics, coprolalia and echolalia lost its paramount significance as shown by currently accepted criteria, providing the basis for earlier diagnosis even in mild cases (DSM-III-R; American Psychiatric Association, 1987). It is widely accepted that GTS is a neuropsychiatric condition, and it has recently been demonstrated by neurophysiological techniques that motor tics are expressed by pathways other than those subserving voluntary movements (Obeso et al, 1981). We report the clinical features of 75 patients with GTS in Argentina evaluated over a 4 year period in the city of Buenos Aires
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