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Tourette syndrome (also called Tourette's syndrome, Tourette's disorder, Gilles de la Tourette syndrome, GTS or, more commonly, simply Tourette's or TS) is an inherited neuropsychiatric disorder with onset in childhood, characterized by multiple physical (motor) tics and at least one vocal (phonic) tic. These tics characteristically wax and wane, can be suppressed temporarily, and are preceded by a premonitory urge. Tourette's is defined as part of a spectrum of tic disorders, which includes provisional, transient and persistent (chronic) tics. Tourette's was once considered a rare and bizarre syndrome, most often associated with the exclamation of obscene words or socially inappropriate and derogatory remarks (coprolalia), but this symptom is present in only a small minority of people with Tourette's.〔Singer HS. "Tourette syndrome and other tic disorders". ''Handb Clin Neurol.'' 2011;100:641–57. PMID 21496613. Also see Singer HS. "Tourette's syndrome: from behaviour to biology". ''Lancet Neurol.'' 2005 Mar;4(3):149–59. PMID 15721825.〕 Tourette's is no longer considered a rare condition, but it is not always correctly identified because most cases are mild and the severity of tics decreases for most children as they pass through adolescence. Between 0.4% and 3.8% of children and adolescents ages 5 to 18 may have Tourette's;〔 the prevalence of other tic disorders in school-age children is higher, with the more common tics of eye blinking, coughing, throat clearing, sniffing, and facial movements. Extreme Tourette's in adulthood is a rarity, and Tourette's does not adversely affect intelligence or life expectancy. Genetic and environmental factors play a role in the etiology of Tourette's, but the exact causes are unknown. In most cases, medication is unnecessary. There is no effective treatment for every case of tics, but certain medications and therapies can help when their use is warranted. Education is an important part of any treatment plan, and explanation and reassurance alone are often sufficient treatment.〔〔Peterson BS, Cohen DJ. "The treatment of Tourette's Syndrome: multimodal, developmental intervention". ''J Clin Psychiatry.'' 1998;59 Suppl 1:62–72; discussion 73–74. PMID 9448671. Quote: "Because of the understanding and hope that it provides, education is also the single most important treatment modality that we have in TS." Also see Zinner 2000.〕 Comorbid conditions (co-occurring diagnoses other than Tourette's) such as attention-deficit hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD) are present in many patients seen in tertiary specialty clinics. These other conditions often cause more functional impairment to the individual than the tics that are the hallmark of Tourette's; hence, it is important to correctly identify comorbid conditions and treat them.〔Du JC, Chiu TF, Lee KM, et al. "Tourette syndrome in children: an updated review". ''Pediatr Neonatol''. 2010 Oct;51(5):255–64. PMID 20951354〕 The eponym was bestowed by Jean-Martin Charcot (1825–1893) on behalf of his resident, Georges Albert Édouard Brutus Gilles de la Tourette (1857–1904), a French physician and neurologist, who published an account of nine patients with Tourette's in 1885. ==Classification== Tics are sudden, repetitive, nonrhythmic movements (motor tics) and utterances (phonic tics) that involve discrete muscle groups.〔Leckman JF, Bloch MH, King RA, Scahill L. "Phenomenology of tics and natural history of tic disorders". ''Adv Neurol.'' 2006;99:1–16. PMID 16536348〕 Motor tics are movement-based tics, while phonic tics are involuntary sounds produced by moving air through the nose, mouth, or throat. Tourette's was classified by the fourth version of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-IV-TR) as one of several tic disorders "usually first diagnosed in infancy, childhood, or adolescence" according to type (motor or phonic tics) and duration (transient or chronic). Transient tic disorders consisted of multiple motor tics, phonic tics or both, with a duration between four weeks and twelve months. Chronic tic disorder was either single or multiple, motor or phonic tics (but not both), which were present for more than a year.〔 Tourette's is diagnosed when multiple motor tics, and at least one phonic tic, are present for more than a year.〔 The fifth version of the DSM (DSM-5), published in May 2013, reclassified Tourette's and tic disorders as motor disorders listed in the neurodevelopmental disorder category, and replaced transient tic disorder with provisional tic disorder, but made few other significant changes.〔(Neurodevelopmental disorders. ) American Psychiatric Association. Retrieved on December 29, 2011.〕〔Moran, M. ("DSM-5 provides new take on neurodevelopment disorders". ) ''Psychiatric News''. 18 January 2013;48(2):6–23. 〕〔("Highlights of changes from DSM-IV-TR to DSM-5" (PDF). ) American Psychiatric Association. 2013. Retrieved on June 5, 2013.〕 Tic disorders are defined only slightly differently by the World Health Organization International Statistical Classification of Diseases and Related Health Problems, ICD-10; code F95.2 is for combined vocal and multiple motor tic disorder (la Tourette ).〔Du, Chiu, Lee, et al. 2010. See also (ICD version 2007. ) World Health Organization. Retrieved on December 29, 2011.〕 Although Tourette's is the more severe expression of the spectrum of tic disorders,〔Bagheri MM, Kerbeshian J, Burd L. ("Recognition and management of Tourette's syndrome and tic disorders". ) ''American Family Physician''. 1999; 59:2263–74. PMID 10221310 Retrieved on October 28, 2006.〕 most cases are mild.〔 The severity of symptoms varies widely among people with Tourette's, and mild cases may be undetected.〔 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Tourette syndrome」の詳細全文を読む スポンサード リンク
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