Parents should not ignore the baby’s little movements!

Tourette syndrome, also known as Tourette syndrome, Tourette syndrome, or combined vocal and multiple motor tics disorder, is a syndrome characterized by multiple involuntary tics, language or behavioral disorders, and is a chronic neuropsychiatric disorder. It usually develops between the ages of 3 and 15, and is more common in boys than in girls.

Generally, they are divided into three categories: motor tics, vocal tics, and sensory tics. Motor tics refer to involuntary, sudden, and rapid contraction of muscles in the face, neck, shoulders, trunk, and limbs, which manifest as blinking, pursing the lips, shrinking the nose, opening the mouth, shaking the head, shrugging the shoulders, etc. If they continue for a certain period of time, they may develop into vocal tics, which are most common in the throat, and tongue muscle tics may also occur. Sensory tics are preceded by some signs, which may be impulses, feelings, or thoughts. At the same time, some patients also have abnormal emotions and other manifestations.

Tourette syndrome is often easily ignored by parents in the early stages of the disease. The symptoms are mild at the beginning, and parents do not agree with the intermittent blinking and shrugging behaviors in the early stages. They do not seek medical treatment and often think that they are bad habits, "minor problems" and "nothing serious", thus delaying medical treatment and diagnosis. Furthermore, children have a certain ability to suppress symptoms, and when they intentionally cover up tics, it is difficult for parents and doctors to detect it. In addition, some doctors believe that Tourette syndrome must have symptoms of coarse talking, but in fact only some patients will show coarse talking symptoms several years after the onset of the disease, thus missing the best time for diagnosis and treatment.

It is worth noting that although this disease is not life-threatening, it is chronic, fluctuating and recurrent, making it difficult to cure. It will affect children's normal learning, life, social interaction and other activities, and increase the burden on families and management difficulties in schools.

Treatment methods are divided into two categories, including drug treatment and non-drug treatment.

1. Drug treatment: including Western medicine and Chinese medicine

The main choices of Western medicine are sulpiride and aripiprazole. Classic Western medicines include sulpiride, haloperidol, clonidine, etc. Due to poor efficacy or adverse reactions, aripiprazole, atomoxetine, immune preparations, etc. are gradually being tried, and some have achieved significant therapeutic effects.

TCM believes that tics belong to the categories of "liver wind", "convulsions", "slow convulsions", etc. With the development of TCM, TCM has shown more and more advantages in the diagnosis and treatment of this disease. TCM believes that this disease is located in the liver, and is closely related to the heart, spleen, and kidney. It is related to the excessive five emotions, internal wind and phlegm, kidney deficiency and liver hyperactivity, phlegm heat disturbing the heart, or spleen deficiency and phlegm dampness. Liver wind and phlegm turbidity are crucial in the onset of this disease. The principles of medication are mostly to clear heat and calm the liver, resolve phlegm and dispel wind, strengthen the spleen and resolve turbidity, and activate blood circulation and stop spasms. Commonly used Chinese patent medicines are: Changma Xifeng Tablets, Ningdong Granules, Jiuwei Xifeng Granules, and Shaoma Zhijing Granules.

2. Non-drug therapy: mainly includes psychological and behavioral therapy, dietary adjustment and other treatments.

Psychological behavioral therapy includes habit reversal training, biofeedback, psychological nursing intervention, etc. In daily care, parents' wholehearted psychological and behavioral support is helpful to the recovery of children. At the same time, parents should strengthen communication and explanation with the school and provide a comfortable environment for children, which is important for improving the symptoms of this disease. However, paying too much attention to the symptoms of children and ignoring the reasonable arrangement of their study and life is not conducive to the treatment of children.

Eat regularly, don't be picky, don't eat partiality, and don't overeat. Foods that are suitable to eat more: vegetables, especially green leafy vegetables, fish, bone marrow, fresh fruits and whole grains, milk, lotus seeds, walnuts, lilies, etc. Foods that are not suitable to eat more: foods containing additives, preservatives, and flavorings, grilled, fried, greasy foods and beverages, tonics, etc. Do not eat foods that easily excite the brain, such as chocolate, tea, and coffee.

Other treatments include traditional Chinese medicine acupuncture, immunotherapy, deep brain stimulation, transcranial magnetic stimulation and surgical treatment.

References:

［1］LI Jijun, WANG Shuzhen, ZHAO Lin, et al. Characteristics of TCM syndromes in 126 children with Tourette syndrome［J］． Chinese Journal of Traditional Chinese Medicine． 2010，51(7):639－641．

［2］Jiao Fuyong, Yan Xianpeng, Xue Ru, et al. New progress in the treatment of Tourette syndrome［J］． Chinese Journal of Medical Science． 2012，2(23):52-53．

［3］Wang Yongyan, Wang Lei, Wang Zhong, et al. A preliminary discussion on the prevention and treatment of tics in children with traditional Chinese medicine［J］． Chinese Journal of Integrated Traditional and Western Medicine． 2022，4(2):148-150．

［4］Dong Liping. Syndrome differentiation and nursing for children with tics［J］． World Latest Medical Information Abstracts． 2019，19（49）：301-302．

Academic authenticity, the author is responsible for the content

Source: Department of Pharmacy, Tianjin Children's Hospital

Author: Wang Yan, Chief Pharmacist

Reviewer: Sun Yanyan, Chief Pharmacist

Yu He, Chief Pharmacist