TIKI

TIKI - repetitive rapid involuntary spasmodic movements, usually involving a limited group of muscles. There are motor tics, vocal tics, sensory tics (unpleasant bodily sensations, passing in the commission of a motor or vocal tic). Tiki included in each of these groups are divided into simple and complex.

Examples of simple motor tics are blinking, twitching his head, shrug, drawing the belly, squinting, examples of complex motor tics -. blows to my body, bouncing, echopraxia (repetition of gestures), copropraxia (play obscene gestures). By a simple vocal tics include coughing, snorting, pohryukivanie, whistling; to complex - echolalia (repeating another's words), pallilaliya (the repetition of the words or sounds), eschrolalia (uttering obscene words). Nosological distinguish primary and secondary tics. Secondary tics associated with taking drugs (antiepileptic drugs, antipsychotic drugs and other drugs antidofaminergicheskih, levodopa, psychostimulants), traumatic brain injury, encephalitis, vascular disease, carbon monoxide poisoning, perinatal pathology. Group primary tics that occur in the absence of a primary disease, divided into transient motor and / or vocal tics lasting less than 1 year, chronic motor or vocal tics, continuing without long remission for 1 year or more, as well as Tourette's syndrome, which is a the combination of chronic motor and vocal tics. These options tics usually begin in childhood and adolescence. Since ticks are often combined obsessive-compulsive disorder, hyperactivity, impulsiveness and attention disorders, complicating patient education. tics usually develop gradually during childhood and remain undetected for as long as the parents are suddenly not pay attention to what the child after a respiratory infection was the constantly sniff, or after suffering a stress began to blink continuously. Tics are often worse in adolescence, and adolescence and young age are reduced.

Treatment. In many cases, medical treatment is necessary and sufficient to reassure the patient and his or her parents, telling about the nature of the disease and pointing to its benign course. It is important to mention that the patient does not threaten the intelligence decline, severe mental or neurological disease, and in most cases, patients are perfectly adapted to life. It is important to alert parents that they should not focus on the child's tics. In the long term goal of treatment is not the suppression of tics, and create conditions for normal training and education of self-control. The role of drug treatment should be limited, as there is no effective means, which would at the same time absolutely safe. Antipsychotics - the most effective means of suppressing tics, should not be used unless absolutely necessary. At the initial stage it is possible to confine a relatively safe means of providing a moderate effect. These include Phenibutum, clonazepam, clonidine. Parts of the patients shows a short low-dose neuroleptics - tiapride, sulpiride (Eglon), pimozide (Orapa), haloperidol. Only in severe cases, prolonged use of neuroleptics is justified, but it is necessary to adhere to the minimum effective dose. Side effects that occur during the initial treatment period (dystonic reactions, parkinsonism symptoms, blurred vision, dysarthria), can be eliminated with the help of anticholinergics (tsiklodol or akineton). As a further means used chewing gum or the nicotine patch, the reinforcing effect of neuroleptics. For the treatment of obsessive-compulsive disorder used clomipramine (Anafranil), sertraline (Zoloft), fluvokasamin for the treatment of attention disorders in schoolchildren - tricyclic antidepressants (imipramine and desipramine) or light stimulants.