Comorbidities in Developmental Disorders – Chapter 3: Gilles De La Tourette Syndrome and its Common Comorbidities (ebook)
Chapter 3 of the book – Gilles De La Tourette Syndrome and its Common Comorbidities
For well over a century after its first description by George Gilles de la Tourette, the syndrome that bears his name was considered a rare and exotic disease. This view has changed considerably. Epidemiological evidence suggests that Gilles de la Tourette syndrome (GTS) may be far more common than previously estimated, and it is now widely accepted that there is a significant genetic contribution to this neuropsychiatric disorder. However, despite the considerable advances in our understanding of GTS, the genetic basis of GTS remains elusive, the pathophysiology is incompletely understood and any interaction between genetic and potential environmental factors is speculative. From a clinical point of view, treating patients with GTS remains challenging because of the complexities of the clinical phenotype. In this chapter we will try to dissect, as much as is possible, GTS and its most frequent comorbidities, in particular attention-deficit–hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). This may help to improve the understanding of the trials and tribulations of patients with GTS; it also forms the basis of a systematic approach to assessment and treatment.
About the complete book
In the last decade the term ’comorbidity’ has gained popularity in the field of paediatric neurodisability, with the increasing recognition that many conditions are rarely present in isolation. Within this field, the term is often used to refer to the co-occurrence of conditions more frequently than would be expected by chance, which can include instances where one condition causes the other, where they share a common cause (for example, genetic), or where they are in fact manifestations of a single condition. Whether it is valid to use the term ’comorbidity’ in all these situations, and how precisely it should be used, is something that the contributors to this book grapple with in their own fields of interest. The contributors, all world experts in their fields, also discuss what we can learn from the presence of comorbidities, however defined, about the aetiology and treatment of neurodevelopmental disabilities. In particular, they demonstrate how our increasing understanding of the mechanisms underlying the common association of many ‘comorbidities’ is helping us to understand the natural history of these conditions and improve our management of them.
Paediatricians, paediatric neurologists, child psychiatrists, neurodevelopmentalists, and physical, occupational and speech therapists working with children with developmental disabilities.
Clinics in Developmental Medicine No. 187