Premonitory urge

Last updated

A premonitory urge is a sensory phenomenon associated with Tourette syndrome and other tic disorders. Premonitory urges are "uncomfortable feelings or sensations preceding tics that usually are relieved by [a particular] movement". [1]

"Individuals with tics may have either a generalized or a localized sensation of tension that is relieved by movement, [that is] the tic." [2] Sensory phenomena in tic disorders include bodily sensations, mental urges, and a sense of inner tension, feelings of incompleteness, and a need for things to be "just right". Bodily sensations include focal or generalized body sensations (usually tactile, muscular-skeletal/visceral, or both); mental sensations include urge only, energy release (mental energy that builds up and needs to be discharged), incompleteness, and just-right perceptions. [3] Published descriptions of the tics of Tourette's identify sensory phenomena as the core symptom of Tourette syndrome, even though they are not included in the diagnostic criteria. [4] [3]

In contrast to the stereotyped movements of other movement disorders such as choreas, dystonias, myoclonus, and dyskinesias, the tics of Tourette's are temporarily suppressible and preceded by this premonitory urge. [5] Immediately preceding tic onset, most individuals with Tourette syndrome are aware of an urge, [6] which is similar to the need to sneeze or scratch an itch. Individuals describe the need to tic as the buildup of tension in a particular anatomical location, [7] which they consciously choose to release, as if the subject "had to do it". [8] Examples of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders. The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch. Another example is blinking to relieve an uncomfortable sensation in the eye. [4]

The presence of sensory phenomena differentiates subjects with Tourette syndrome plus obsessive–compulsive disorder (OCD) from subjects with OCD alone, [9] and may be an important measure for grouping patients along the OCD-Tourette's disorder spectrum. [3]

Related Research Articles

<span class="mw-page-title-main">Tourette syndrome</span> Neurodevelopmental disorder involving motor and vocal tics

Tourette syndrome or Tourette's syndrome is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency. Tourette's is at the more severe end of a spectrum of tic disorders. The tics often go unnoticed by casual observers.

<span class="mw-page-title-main">Coprolalia</span> Involuntary utterance of socially inappropriate words

Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks. The word comes from the Greek κόπρος, meaning "dung, feces", and λαλιά "speech", from λαλεῖν "to talk".

<span class="mw-page-title-main">Tic</span> Sudden movement or vocalization

A tic is a sudden and repetitive motor movement or vocalization that is not rhythmic and involves discrete muscle groups. It is typically brief and may resemble a normal behavioral characteristic or gesture.

Sensory overload occurs when one or more of the body's senses experiences over-stimulation from the environment.

<span class="mw-page-title-main">PANDAS</span> Hypothesis in pediatric medicine

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) is a diagnosis for a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders. Symptoms are proposed to be caused by group A streptococcal (GAS), and more specifically, group A beta-hemolytic streptococcal (GABHS) infections. OCD and tic disorders are hypothesized to arise in a subset of children as a result of a post-streptococcal autoimmune process. The proposed link between infection and these disorders is that an autoimmune reaction to infection produces antibodies that interfere with basal ganglia function, causing symptom exacerbations, and this autoimmune response results in a broad range of neuropsychiatric symptoms.

<span class="mw-page-title-main">Tic disorder</span> Range of neurodevelopmental conditions

Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type and duration of tics. Tic disorders are defined similarly by the World Health Organization.

<span class="mw-page-title-main">Intrusive thought</span> Unwelcome involuntary thought, image or idea

An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. When such thoughts are associated with obsessive–compulsive disorder (OCD), Tourette syndrome (TS), depression, body dysmorphic disorder (BDD), and sometimes attention deficit hyperactivity disorder (ADHD), the thoughts may become paralyzing, anxiety-provoking, or persistent. Intrusive thoughts may also be associated with episodic memory, unwanted worries or memories from OCD, post-traumatic stress disorder (PTSD), other anxiety disorders, eating disorders, or psychosis. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, and generally have aggressive, sexual, or blasphemous themes.

Societal and cultural aspects of Tourette syndrome include legal advocacy and health insurance issues, awareness of notable individuals with Tourette syndrome, and treatment of TS in the media and popular culture.

Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of motor and phonic tics. The management of Tourette syndrome has the goal of managing symptoms to achieve optimum functioning, rather than eliminating symptoms; not all persons with Tourette's require treatment, and there is no cure or universally effective medication. Explanation and reassurance alone are often sufficient treatment; education is an important part of any treatment plan.

Causes and origins of Tourette syndrome have not been fully elucidated. Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane. Tourette's syndrome occurs along a spectrum of tic disorders, which includes transient tics and chronic tics.

Arthur K. Shapiro, M.D., was an American psychiatrist and expert on Tourette syndrome. His "contributions to the understanding of Tourette syndrome completely changed the prevailing view of this disorder"; he has been described as "the father of modern tic disorder research" and is "revered by his colleagues as the first dean of modern Tourette syndrome researchers".

Sensory phenomena are general feelings, urges or bodily sensations. They are present in many conditions including autism spectrum disorders, epilepsy, neuropathy, obsessive–compulsive disorder, pain conditions, tardive syndromes, and tic disorders.

Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders".

The obsessive–compulsive spectrum is a model of medical classification where various psychiatric, neurological and/or medical conditions are described as existing on a spectrum of conditions related to obsessive–compulsive disorder (OCD). "The disorders are thought to lie on a spectrum from impulsive to compulsive where impulsivity is said to persist due to deficits in the ability to inhibit repetitive behavior with known negative consequences, while compulsivity persists as a consequence of deficits in recognizing completion of tasks." OCD is a mental disorder characterized by obsessions and/or compulsions. An obsession is defined as "a recurring thought, image, or urge that the individual cannot control". Compulsion can be described as a "ritualistic behavior that the person feels compelled to perform". The model suggests that many conditions overlap with OCD in symptomatic profile, demographics, family history, neurobiology, comorbidity, clinical course and response to various pharmacotherapies. Conditions described as being on the spectrum are sometimes referred to as obsessive–compulsive spectrum disorders.

<span class="mw-page-title-main">History of Tourette syndrome</span>

Tourette syndrome (TS) is an inherited neurological disorder that begins in childhood or adolescence, characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic.

<span class="mw-page-title-main">Obsessive–compulsive disorder</span> Mental and behavioral disorder

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function.

James Frederick Leckman is an American child psychiatrist and psychoanalyst and the Neison Harris Professor of Child Psychiatry, Psychiatry, Psychology and Pediatrics at the Yale School of Medicine, recognized for his research in Tourette syndrome (TS) and obsessive–compulsive disorder (OCD).

<span class="mw-page-title-main">Euripedes Constantino Miguel</span> Brazilian psychiatrist (born 1959)

Euripedes Constantino Miguel Filho is a Brazilian psychiatrist and professor who is head of the Department of Psychiatry at FMUSP and associate adjunct professor at the Yale University School of Medicine. Between 2009 and 2019, he was an associate professor in the Department of Psychiatry at Duke University and, from 2009 to 2014, a research consultant at Massachusetts General Hospital, Harvard Medical School.

The Yale Global Tic Severity Scale (YGTSS) is a psychological measure designed to assess the severity and frequency of symptoms of disorders such as tic disorder, Tourette syndrome, and obsessive-compulsive disorder, in children and adolescents between ages 6 and 17.

John Piacentini, PhD, ABPP, is an American clinical child and adolescent psychologist, and professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA in Los Angeles, California. He is the director of the Center for Child Anxiety, Resilience, Education and Support (CARES), and the Child OCD, Anxiety and Tic Disorders Program at UCLA's Semel Institute for Neuroscience and Human Behavior.

References

  1. ↑ "Definitions and classification of tic disorders. The Tourette Syndrome Classification Study Group". Arch. Neurol. 50 (10): 1013–6. October 1993. doi:10.1001/archneur.1993.00540100012008. PMID   8215958. Archived from the original on 2005-03-22.
  2. ↑ Kurlan R, Lichter D, Hewitt D (May 1989). "Sensory tics in Tourette's syndrome". Neurology. 39 (5): 731–4. doi:10.1212/wnl.39.5.731. PMID   2710364. S2CID   42132652.
  3. 1 2 3 Miguel EC, do Rosário-Campos MC, Prado HS, et al. (February 2000). "Sensory phenomena in obsessive-compulsive disorder and Tourette's disorder". J Clin Psychiatry. 61 (2): 150–6, quiz 157. doi:10.4088/jcp.v61n0213. PMID   10732667.
  4. 1 2 Scahill LD, Leckman JF, Marek KL (1995). "Sensory phenomena in Tourette's syndrome". Adv Neurol. 65: 273–80. PMID   7872145.
  5. ↑ Jankovic J (2001). "Differential diagnosis and etiology of tics". Adv Neurol. 85: 15–29. PMID   11530424.
  6. ↑ Cohen AJ, Leckman JF (September 1992). "Sensory phenomena associated with Gilles de la Tourette's syndrome". J Clin Psychiatry. 53 (9): 319–23. PMID   1517194.
  7. ↑ Bliss J (December 1980). "Sensory experiences of Gilles de la Tourette syndrome". Arch. Gen. Psychiatry. 37 (12): 1343–7. doi:10.1001/archpsyc.1980.01780250029002. PMID   6934713.
  8. ↑ Kwak C, Dat Vuong K, Jankovic J (December 2003). "Premonitory sensory phenomenon in Tourette's syndrome". Mov. Disord. 18 (12): 1530–3. doi:10.1002/mds.10618. PMID   14673893. S2CID   8152205.
  9. ↑ Miguel EC, do Rosário-Campos MC, Shavitt RG, Hounie AG, Mercadante MT (2001). "The tic-related obsessive-compulsive disorder phenotype and treatment implications". Adv Neurol. 85: 43–55. PMID   11530446.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.