The progress on diagnosis and treatment of functional tics

doi:10.3969/j.issn.1672-6731.2023.06.011

Abstract

Abstract:

Functional tics is one type of functional movement disorders (FMD) with overlapping clinical manifestations of primary tics. It is difficult to distinguish them in clinical practice. In this text, we will introduce the epidemiology, risk factors, clinical features, diagnosis and treatment of functional tics by comparing with primary tics (especially Tourette's syndrome), with the aim to improve the rate of accurate diagnosis, and avoid misdiagnosis and mistreatment.

Key words: Conversion disorder, Tic disorders, Review

摘要：

功能性抽动是功能性运动障碍的一种亚型, 其临床表现与原发性抽动症存在交叉与重叠, 鉴别诊断存在一定困难。本文拟对功能性抽动的流行病学以及危险因素、临床特征、诊断与治疗等相关内容进行概述, 并与原发性抽动症(特别是抽动秽语综合征)相比较, 以提高临床诊断准确率, 避免误诊误治。

关键词: 转换障碍, 抽搐性运动障碍, 综述

Xin-yi XIE, Yu-han JIANG, Wei CHEN. The progress on diagnosis and treatment of functional tics[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(6): 535-538.

谢心怡, 姜雨菡, 陈伟. 功能性抽动诊断与治疗[J]. 中国现代神经疾病杂志, 2023, 23(6): 535-538.

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URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2023.06.011

https://journal11.magtechjournal.com/cjcnn/EN/Y2023/V23/I6/535

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鉴别点	抽动秽语综合征	功能性抽动	共性症状
临床特征	童年期发病；阵挛性抽动常见；抽动呈头尾分布；病程呈消长变化	成年期发病；主要累及手臂和（或）躯干；情境依赖性和症状高度可变性；发作过程易被自主动作干扰；其他功能性神经系统症状与体征	不自主表达不被社会接受的言语或手势（coprophenomena）；感觉先兆；可抑制性
危险因素	家族史和（或）遗传因素；男性多见	创伤性诱因；述情障碍	强迫症；生活重大事件
治疗方法	抗精神病药物；α2-肾上腺素受体激动药；肉毒毒素	心理治疗；运动训练；对抗抽动药物无典型反应	认知行为疗法；抗焦虑药物和（或）抗抑郁药物

鉴别点	抽动秽语综合征	功能性抽动	共性症状
临床特征	童年期发病；阵挛性抽动常见；抽动呈头尾分布；病程呈消长变化	成年期发病；主要累及手臂和（或）躯干；情境依赖性和症状高度可变性；发作过程易被自主动作干扰；其他功能性神经系统症状与体征	不自主表达不被社会接受的言语或手势（coprophenomena）；感觉先兆；可抑制性
危险因素	家族史和（或）遗传因素；男性多见	创伤性诱因；述情障碍	强迫症；生活重大事件
治疗方法	抗精神病药物；α2-肾上腺素受体激动药；肉毒毒素	心理治疗；运动训练；对抗抽动药物无典型反应	认知行为疗法；抗焦虑药物和（或）抗抑郁药物

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