Tourette's%20syndrome%20-and-%20other%20tic%20disorders Signs and Symptoms

Signs and Symptoms

Definition

Tics

Sudden, rapid, non-rhythmic, repetitive, motor movements or vocalizations
Mean age of onset is approximately 5 years with peak severity occurring between 10-12 years of age and declining in many children during adolescence
There is a strong genetic component showing a 10- to 100- fold increase in the rates of tics & Tourette syndrome (TS) among 1st-degree relatives of Tourette syndrome patients

Etiology

Primary Causes of Tic Disorders

Inherited Tic Disorders

Tourette syndrome (TS)
Huntington’s disease
Primary dystonia
Neuroacanthosis

Sporadic Tics

Transient motor or phonic tics (<1 year duration)
Chronic motor or phonic tics (>1 year duration)
Adult-onset (recurrent tics)
Tourette syndrome

Secondary Causes of Tic Disorders

Primary Neurologic Disorders

Head trauma
Stroke
Encephalitis
Carbon monoxide poisoning
Neurosyphilis
Sydenham’s chorea
Hypoglycemia
Down syndrome
Tuberous sclerosis
Fragile X syndrome
Klinefelter’s syndrome
Chromosomal disorders
XYY karyotype
Duchenne’s disease
Hallervorden-Spatz disease
Creutzfeldt-Jakob disease

Primary Neuropsychiatric Disorders

Mental retardation
Schizophrenia
Asperger’s syndrome/autism

Drugs Which May Induce or Worsen Tics

Stimulants (eg Methylphenidate, Amphetamines, Pemoline)
Cocaine
Antipsychotics
Antidepressants
Anticonvulsants
Antihistamines
Lithium
Opioids & opioid withdrawal
Levodopa

Other movement disorders that need to be ruled out:

Eg myoclonic movements, torsion dystonia, chorea, stereotypies

Spotlight on multidrug-resistant gram-negative infections: New developments for an old problem

Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021

Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.