Release: Embargoed until September 24, 2000Contact: Kenneth Satterfield202-371-4517 (9/23-27)703-519-1563[email protected]
TOURETTE SYNDROME SYMPTOMS OFTEN ARE EXPRESSED AS EAR, NOSE, AND THROAT DISORDERS
Facial and vocal tics cause many to erroneously seek treatment from an otolaryngologist. A new study recommends more patient and physician awareness of this neurological disorder
Washington, DC -- Tourette syndrome is a neurologic disorder manifested by both vocal and complex motor tics. The disorder, which almost always starts in childhood, is much more common than originally believed. Due to physician and/or patient oversight, the diagnosis is often delayed. In that many of the presenting symptoms involve the head and neck, the otolaryngologist is often called on to assess these patients.
A new study suggests that certain pediatric patients are brought in for an evaluation by an otolaryngologist--head and neck surgeon because of vocal or facial tic disorders. These symptoms may actually be caused by Tourette syndrome, necessitating a diagnostic examination by a neurologist. The study's conclusions call for ear, nose, and throat specialists to be aware of this neurological disorder and its symptoms.
The author of the study, "Otolaryngologic Manifestations of Tourette Syndrome," is Lorne S Parnes, MD from London, Canada. Her findings will be presented Wednesday, September 27 at the Annual Meeting of the American Academy of Otolaryngology -- Head and Neck Surgery Foundation, being held September 24-27, 2000, at the Washington, DC Convention Center.
Methodology: Three patients ultimately diagnosed with Tourette syndrome are presented to demonstrate the pertinent otolaryngologic features of this disorder.
Results: Case One is a nine year-old boy, referred for assessment of eustachian tube dysfunction. For 3 years he complained of pressure in both ears necessitating almost continual autoinsufflation and lower jaw movement. Tympanostomy tubes had failed to alleviate his symptoms. Further history revealed other complex vocal and motor tics.
Case Two is a nine year-old boy under care for enlarged vestibular aqueduct syndrome. During one routine follow-up visit, he displayed lip licking and stretching, eye blinking, and arm and shoulder tics. On further questioning, we found that these and other tics had been waxing and waning for more than one year.
Case Three is an 11-year-old boy referred for assessment of nasal stuffiness. Related symptoms included chronic sniffing and throat clearing, but unrelated findings included eye tics, vocal tics, and hyperactivity.
Conclusion: Patients with Tourette syndrome, most commonly young males, may be referred to the otolaryngologist for assessment of various phonic/vocal or oral/facial motor tics. The disorder may also be diagnosed coincidentally. Many of these individuals also have comorbid disorders including attention deficit----hyperactivity disorder and obsessive-compulsive disorder. Awareness and recognition are extremely important, allowing for prompt diagnosis and earlier intervention. This will avoid multiple referrals to various specialists, an all too common occurrence for these individuals.
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