Showing posts with label Tourette syndrome. Show all posts
Showing posts with label Tourette syndrome. Show all posts

Friday, August 19, 2016

10 THINGS YOU SHOULDN’T SAY TO SOMEONE WHO HAS TOURETTE’S SYNDROME

1.) “You’re really pretty/ handsome for someone with Tourette’s” or “You’re too pretty/handsome to have Tourette’s”
Yes. People actually say this. Or at least make comments like this online.
In responce to this, here are the words of a beautiful young woman named Megan who has Tourette’s:
“Are you saying that people who have disabilities or neurological conditions are not supposed to be aesthetically pleasing or to have a certain beauty that fits in what society finds acceptable? This warped sense of beauty? What if your child has a disability and you tell them that they are too normal or beautiful to have a disability? Imagine how they’d feel? And you know what? I have Tourette’s and I am gosh damn sexy, beautiful, confident, wonderful, amazing, compassionate, loving, caring, considerate, resilient, and strong-minded. Tourette’s has made me become so much more compassionate towards other people. Tourette’s has helped me learned cultural competency and enables me to connect with ANYONE at ANY TIME on a mental, emotional, and spiritual level. Now that’s beautiful.” 
2.) “I have this eye twitch when I get stressed so I know exactly what you’re going through.” 
From Jenn, a mother of two children with Tourette’s:
“Really? all day every day for weeks months and years? wow. You may want to get that checked out (depending on how long they have it). If its not something serious then politely change the topic. Some people don’t realize how they come across. My friends daughter says things like this ALL the time.. some days my daughter cries.. other days she will laugh.”
3.) “Can’t you just stop?” 
From Kerri, a mother of a 13 year old son with Tourette’s:
“I like to say to those people that if he (son, 13yo) could stop, he would. It bothers him a whole lot more than it will EVER bother you. It’s a lot like a staring contest: when you keep yourself from blinking for an extended amount of time, once you give in & blink, your eyes burn & you blink a whole lot more to ease the burning in your eyes. Same with stopping/curbing his tics. And no, he won’t stop.”
From Jo, an adult living with Tourette’s:
I often have a hard time getting people who do not have TS to understand why I can’t ‘just stop’. I liken it to not blinking. How long can you NOT blink for? Sometimes we have a certain degree of control over our tics, sometimes we have none and sometimes we can suppress for short amount of time but that tension then builds. So, if you did not blink for 5 minutes your eyes would become so dry/watery and stinging that when you were allowed to blink again you would blink uncontrollably and repeatedly to make up for the lack of blinking until your eyes felt better again. Yeah, that’s what it’s like to NOT tic.
4.) “Maybe if you disciplined your child more or if you weren’t such an anxious parent then they wouldn’t have Tourette’s”  

From Melissa:
“Tourette Snydrome is not something that can be controlled no matter what type of discipline is used. It’s a genetic neurological disroder”
From Brynn, a mother of a child with Tourette’s:
“I would say to them ” do you know what TS is? Do you remember how painful it was to watch your child be in pain as an infant and not be able to do a think about it? I live that everyday with my child, and yes that makes me an anxious parent, but not about her tics or her future. You see, I have raised her to be strong and be proud of all of who she is. What makes me an anxious parent are closed minded people like you that she will undoubtedly encounter in her life. What makes me an axious parent are the hopes that she shows herself as a christian to undiciplined opinions and words like yours.”
5. )”With your effort and attitude, I know you’ll get rid of your tics one day.” 

From Charlotte, an adult living with Tourette’s:

Why would you think that? I’m almost 64 and probably the only time my face will stop moving will be when I’m in my coffin!”
6.) “I wish I had Tourette’s too! Then I could go around swearing and saying anything I want to and I would never get in trouble!” 

From Jenn, a mother of two children with Tourette’s:
“This made me cry – just moved into our neighborhood.. the lady over at the church whose husband is the pastor said she wished she had Tourette syndrome to my son and I and then said because then she could take the lords name in vein. In that moment I was shocked. I smiled at her as if to say I cant believe you said that.. then I said I had to get going – thanks for the chat.. and we left. My son was so upset and wanted to know why I didn’t say anything to her especially since I always say something but I looked at him and said there are some people that are not worth explaining to..”

From Lauren, an adult living with Tourette’s:
“I have actually had that comment made to me by a man who had his Doctoral degree in Social Work, very educated. I explained to him that I was very hurt by what he said and i educated him about what it is like to have Tourette’s and that it is not just a cussing disorder. It was a good learning opportunity for him.”

7.) “You don’t have Tourette’s! You seen so normal. I’ve never even seen you tic.” 

From Darby, a mother of a child with Tourette’s:
“I hear this all the time. Tourette’s is so misunderstood even by medical professionals. My response would depend on the situation. Sometimes I don’t have the time or energy to educate others and I just say, “well you don’t see us much and how it impacts our lives day to day and 24/7.” If I have time, I try to give them some insight and specifics. But, usually they still think I am making things up to excuse my kid’s “behavior.” They don’t get it. And inevitably they want to know why I just don’t make him stop. I recently had someone tell me I should duct tape his mouth shut. People can really be ignorant. I don’t waste anymore time on these people. We try to surround ourselves with people who are kind and understanding. The rest of them have no place in our lives.”

From Mandy, a mother of a child with Tourette’s:
“Certain things make my sons tics act up, excitement, anxiety, etc. He doesn’t tic all the time.”
From Asher, someone living with Tourette’s:
“I can assure you that my tics are very visible to me. They consistently provide adversity in my life, and thus, I can also assure you that I have Tourette Syndrome (And I was diagnosed).”
From Jen, a mother of two children with Tourette’s:
“AH I get this all the time. The answer always depends on the person saying it. I usually say this – Yeah, my kids don’t really tic around others. They try really hard to suppress them in front of strangers or people they know but are uncomfortable around. Take a look sometime at their youtube videos.. lots of tics on those! : ) Maybe you can look it up, its not uncommon for people to not notice. And yes they are normal, thanks”
From Kerri, a mother of a child with Tourette’s:
My son (13) tics constantly & people say this to me all of the time! I tell them they just don’t know what tics are & that not all of them are screaming, in your face tics. I tell them he always tics, they just may not realize it. Once I describe the tics he is currently having, they usually say, “Oh, I’ve seen him do those! Those are tics?! I had no idea.” I don’t mind educating people when they say it out of a place of genuine ignorance & not stupidity (yes, there is a difference!). Otherwise I would respond with one of the above comments.”
From Heather, a mother of a child with Tourette’s:
“TS isn’t always like Hollywood portrays. Often there is much more going on you can’t see”
8.) “Everyone has “habits”. If you have Tourette’s then everyone does too.”

From Heather, a mother of a child with Tourette’s:
“Habits do not prevent you from doing ordinary things like riding a bike, wearing roller skates or ski boots. Habits do not make you lick your lips until they are puffy and sore. Habits do not prevent you from sitting in a chair. Habits do not make your eyes blink so hard and often you can’t read.”

9.) “Don’t worry, I think I have Tourette’s too half the time” 

From Jenn, a mother of two children with Tourette’s:
“Wow. What exactly is it that you do that would lead you to believe you actually have Tourette Syndrome? ( one of two things will happen.. they will either have the symptoms or they wont – if they do then help them and if they don’t then be kind enough to lead them in a more appropriate disorder.. either with a medical name or like in my many circumstances a disorder called Stupidity”
10.) “You just need to exercise more, then you won’t be so hyperactive.”  

From Victoria:
“If that were true, then why do so many professional athletes still have TS? Although exercise helps, it will not cure TS. Same with removing nitrates and other processed food triggers- it will help, but will not cure the underlying disease.”

From Kerri, a mother of a 13 year old son with Tourette’s: 
“He (son, 13yo) is a runner & a swimmer. I’m sure he exercises more than you. It helps but does not make it go away.”
From Jo, an adult living with Tourette’s:
“I do two aerobics sessions a week plus a busy, on my feet job and I do voluntary work two mornings a week, am a single parent to two teenage boys, one with ADHD. I’d say I do my fair share of exercise…strangely I still have Tourette’s. Go figure.”


Source:
http://dailyrecords.us/10-things-you-shouldnt-say-to-someone-who-has-tourettes-syndrome/

Sunday, August 7, 2016

ROLE OF NEURO-HYPNOTHERAPY IN HELPING PEOPLE WITH TIC DISORDER - By Hiro Koo

ROLE OF NEURO-HYPNOTHERAPY IN HELPING PEOPLE WITH TIC DISORDER



Neuro-hypnotherapy is practiced by licensed clinical hypnotherapist who has been trained in the area of EEG biofeedback technique. Neuro-hypnotherapy is first of its kind in Malaysia developed by Hiro Koo. It is based on the concept of clinical hypnotherapy which can be classified as psychotherapy as well. It is well known to deal with the subconscious mind directly and is commonly used to deal with symptoms of various problems such as habit breaking, smoking cessation, weight management, and mood-related issues. There are many approaches and techniques in the field of clinical hypnotherapy. The most commonly used clinical hypnotherapy techniques for patient with tic disorder are hypno-behavioural methods such as hypno-desensitization and habit reversal therapy. Cognitive behavioural hypnotherapy (CBH) can also be used to deal with tic disorder or the comorbid feature of TS such as OCD or anxiety related symptoms.

Neuro-hypnotherapy for tic disorder includes a combination of different types of therapies.  The first step of the neuro-hypnotherapy is psychoeducation. During this initial step, the possible causes of tic disorder will be elaborated by the clinical hypnotherapist. Patients will be guided on ways to communicate with the school or co-workers effectively to prevent conflict and misunderstanding, while their caregivers will be educated on ways to provide appropriate amount of support. Furthermore, although habit reversal is an effective intervention for tic disorder, individuals should be informed that tic disorder is not just a bad habit but neurological disorder. Thus, it cannot be solved based on positive or negative reinforcement alone, let alone the possibility that reinforcement in either positive or negative manner may worsen the symptoms. It is very important to neutralize the self-defeating belief, while empowering the patient and setting realistic expectations.

The following sessions will focus on functional intervention, cognitive behavioural hypnotherapy, HRT, as well as relaxation therapy. During the functional intervention session, patient will be hypnotized in order to identify how environmental factors may worsen, maintain or improve the symptoms. Patient is able to observe his or her behaviour before and after the tics occurrence during the neuro-hypnotherapy session. CBH technique can then be applied to deal with the irrational feelings, cognitive distortion, and unhealthy coping ways.

According to the systematic review done by Dutta and colleague (2013), HRT can significantly reduce tic severity for patient with tic disorder. During the neuro-hypnotherapy session, the hypnotized patient will observe all of their tics in detail such as how it feels in the particular muscle group and where it feels most intensively in the body. During this stage, HRT will be incorporated into neuro-hypnotherapy session to find out the premonitory urge. Thus, patient will notice how it feels before the tics occur more clearly. Hypno-desensitization focuses on helping patient getting used to the premonitory urge, so that the patient doesn’t need to react to it by doing the tic. In this way, premonitory urge can be controlled before the tic happens. Soon after the patient becomes more aware of the premonitory urge, competing response will be discussed and implemented. During the neuro-hypnotherapy session, an intentional movement that can prevent tic from happening will be suggested. After that, the clinical hypnotherapist will use the hypno-exposure therapy to reinforce the competing response.  

Progressive hypnotherapy relaxation is taught to relax the patient as it can directly reduce the stress response. Tics are commonly known to become worse when triggered by stress. Progressive hypnotherapy relaxation technique which requires patient to progressively tensing and then relaxing the different muscle groups is taught in a self hypnosis format. This is a very helpful method to reduce the arousal level in the brain and empower the patient with positive coping strategy. Patient was taught to utilize this progressive hypnotherapy relaxation technique whenever he or she has the need to stay calm and relax.


During the neuro-hypnotherapy session, electrodes are applied to the individual’s scalp, which allows the patient and therapist to observe the brainwave activity. The electrodes do not hurt and conduct no amount of electricity that one can feel. The person’s hair is not removed or shaven during the electrode placement. This is done in real-time setting, so the individuals see exactly what is going on in their brain as they think of certain thoughts, feel stressed, or relaxed. After the self hypnosis session, patient commonly will learn how to self regulate their brain activity naturally, without pharmaceutical medications.





Retrieved from the Integrative treatment for tics and tourette syndrome in Malaysia (Author: Hiro Koo).


References
Bronfeld, M. & Bar-Gad, I. (2013). Tic disorders: What happens in the basal ganglia?
Neuroscientist, 19, 101-108. doi:10.1177/1073858412444466
Dutta, N., & Cavanna, A. E. (2013). The effectiveness of habit reversal therapy in the
treatment of Tourette syndrome and other chronic tic disorders: A systematic review. Functional Neurology, 28((1), 7-12. Retrieved from http://www.ncbi.nlm.nih.gov /pubmed/23731910
Kaya, Y., & Alladin, A. (2012). Hypnotically assisted diaphragmatic exercises in the
            treatment of stuttering: A preliminary investigation. International Journal of Clinical
and Experimental Hypnosis, 60(2), 175-205. doi:10.1080/00207144.2012.648063
Lam, T. (2013). Hypnosis for insomnia: An exaggerated myth or an underrated intervention. 
Sleep Medicine, 14(1). doi:10.1016/j.sleep.2013.11.412
Messerotti, B. S., Buodo, G., Leone, V., & Palomba, D. (2011). Neurofeedback training for
Tourette Syndrome: An uncontrolled single case study. Applied Psychophysiology and Biofeedback36(4), 281-288. doi: 10.1007/s10484-011-9169-7
Abbot, N. C., Stead, L. F., & Barnes, J. (2008). Hypnotherapy for smoking cessation (Review).The Cochrane
  Library, (10), 1 – 39. Retrieved from http://bscw.rediris.es/pub/bscw.cgi/d5001301/Barnes-
  Hypnotherapy_smoking_cessation.pdf
Piacentini, J. C., & Chang, S. W. (2006). Behavioral treatments for tic suppression: Habit
reversal training. Advances in Neurology, 99, 227-233. Retrieved from http://www. ncbi.nlm.nih.gov/pubmed/16536370
Shanbao, T., & Nitish, V. T. (2009). Quantitative EEG analysis methods and clinical
applications. UK: Artech House

Thursday, August 4, 2016

Integrative treatment for tics and tourette syndrome in Malaysia - By Hiro Koo






INTRODUCTION
Human brain can be trained at any age and new neurons are produced throughout our life. The term of neuroplasticity is well accepted nowadays.  EEG biofeedback or neurofeedback is based on the concept of neuroplasticity that trains the brain like a muscle. It is safe, non-invasive, with no known side effects. It is basically based on the principle of operant conditioning which utilizes the reinforcement concept to change the brain.
When it comes to neurological or mental disorders, pharmaceutical intervention is usually recommended to deal with the brain by improving neurochemical or brain structure components. Interestingly, the electrical component which is brainwaves has been neglected most of the time. Even a person with perfect neurochemical and brain structure but without any noticeable brainwaves, this can be certified as brain death by a qualified neurologist or physician. Thus, brainwaves intervention such as EEG biofeedback training should be included as one of the treatment plans while dealing with issues related to our brain and mind. In fact, EEG biofeedback is not something new as it has more than 50 years of established scientific studies. It is proven to be helpful in cases such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), anxiety, insomnia, depression, and tics and Tourette Syndrome. EEG biofeedback for tic disorder is worth investigating as it directly deals with the brain. Another major benefit is the hope that it can help patients avoid pharmaceutical intervention which might cause side effects. As mentioned earlier, a healthy state of brain includes the component of electrical, brain structure and neurochemical. EEG biofeedback alone might not be sufficient to get rid of the entire problem as it primarily improves the brain function to perform better. In this case, integrative treatment approach such as combining with psychotherapy, hypnotherapy, and nutritional therapy can be recommended to get the best therapeutic outcome.

Neuro-hypnotherapy on the other hand, is the first of its kind in Malaysia. It is a technique by combining EEG biofeedback technology and the science of hypnosis. Hypnosis is a skill which involves the use of words and suggestions to achieve therapeutic outcome, while the clinical hypnotherapy is a technique which utilizes the concept of hypnosis to achieve clinical outcomes (Kaya & Alladin, 2012). Clinical hypnotherapy has been acknowledged as an evidence based therapy tool by various medical councils in the world and it has been proven to be helpful for various medical conditions (Abbot NC, Stead LF, White AR, Barnes J, Ernst E., 2008). Clinical hypnotherapy is considered as the oldest form of psychotherapy as well as complementary medicine (Lam, 2013). By utilizing this technique, we can combine self-hypnosis method with other psychotherapy method such as habit reversal training. Habit reversal training (HRT) is evidence based non-pharmaceutical interventions for tics and Tourette syndrome, which has been found to alleviate motor and vocal tics (Piacentini & Chang, 2006). Once patients learn the self-hypnosis technique, they learn to deal with their stressors and healthier ways to remain calm. 

Tourette Syndrome (TS) or Gilles de la Tourette Syndrome is one type of Tic disorder. TS is characterized by involuntary tics, repetitive movements, and vocalizations. Normally it will start between the ages of 5-7 years old and becoming more severe between the ages of 8-12 years old. Motor tics (simple or complex motor tics) and vocal/phonic tics (simple and complex vocal tics) are two common characteristics of tic disorder. Simple motor tics include eye blinking, head jerking, jaw movements, shoulder shrugging, neck stretching, and arm jerking. Complex motor tics include hopping, twirling, and jumping. Simple vocal tics include sniffing, throat clearing, grunting, hooting, and shouting. Complex vocal tics include words which may or may not be recognizable or it could be socially unacceptable words. Tic disorder can be differentiated into three types which is Tourette Syndrome, Chronic Tic Disorder (Vocal or motor type), and Provisional Tic Disorder. Individual with at least two motor tics and at least one vocal/phonic tics over the course of more than 1 year can be classified as TS. One suffered with either motor tics or vocal/phonic tics for more than 1 year can be classified as Chronic Tic Disorder. If the tics were presented less than 1 year, it can be classified as provisional tics disorder. Patients with TS are at high risk of having comorbid major neurodevelopmental and neuropsychiatric conditions such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), Learning difficulties, behavior problems, anxiety, mood issues, social skills deficits, or sleep related problems.

Author: Hiro Koo






References
Bronfeld, M. & Bar-Gad, I. (2013). Tic disorders: What happens in the basal ganglia?
Neuroscientist, 19, 101-108. doi:10.1177/1073858412444466
Dutta, N., & Cavanna, A. E. (2013). The effectiveness of habit reversal therapy in the
treatment of Tourette syndrome and other chronic tic disorders: A systematic review. Functional Neurology, 28((1), 7-12. Retrieved from http://www.ncbi.nlm.nih.gov /pubmed/23731910
Kaya, Y., & Alladin, A. (2012). Hypnotically assisted diaphragmatic exercises in the
            treatment of stuttering: A preliminary investigation. International Journal of Clinical
and Experimental Hypnosis, 60(2), 175-205. doi:10.1080/00207144.2012.648063
Lam, T. (2013). Hypnosis for insomnia: An exaggerated myth or an underrated intervention. 
Sleep Medicine, 14(1). doi:10.1016/j.sleep.2013.11.412
Messerotti, B. S., Buodo, G., Leone, V., & Palomba, D. (2011). Neurofeedback training for
Tourette Syndrome: An uncontrolled single case study. Applied Psychophysiology and Biofeedback, 36(4), 281-288. doi: 10.1007/s10484-011-9169-7
Abbot, N. C., Stead, L. F., & Barnes, J. (2008). Hypnotherapy for smoking cessation (Review).The Cochrane
  Library, (10), 1 – 39. Retrieved from http://bscw.rediris.es/pub/bscw.cgi/d5001301/Barnes-
  Hypnotherapy_smoking_cessation.pdf
Piacentini, J. C., & Chang, S. W. (2006). Behavioral treatments for tic suppression: Habit
reversal training. Advances in Neurology, 99, 227-233. Retrieved from http://www. ncbi.nlm.nih.gov/pubmed/16536370
Shanbao, T., & Nitish, V. T. (2009). Quantitative EEG analysis methods and clinical
applications. UK: Artech House

Tourette syndrome therapy malaysia - H Case


“Stress has made my son’s tics worst. My son is diagnosed with Tourette syndrome and his condition turned distressing when he was 15 years old, the year when he would sit for his PMR examination. Hamzah’s tics are very obvious, believed to be caused by the stress he received from the important exam and it had caused an impact to his academic performance. He could not control his tics as it affected his writing and concentration. Even though he was given extra time in exam, it was still very difficult for him to complete it due to his uncontrollable movement and his low concentration level. Not only that, his daily-struggle includes dealing with the jokes and sarcastic statements made by his school mates.”
“It was suffering to see him going through all these difficulties. I started to seek for all kinds of treatments for Tourette syndrome. But it is disappointing that there are not much treatments for Tourette syndrome in Malaysia. H is taking medications prescribed by hospital though it helps him to relax a bit, I would still want to look for a better solution for him. Then, I found here. I’d read through the testimonials regarding the Brain Trainer therapy in the website and the outcomes of the therapy gave me confidence to bring H here.”
“I’d been introduced to Brain Trainer, the EEG-Biofeedback treatment which can help to relieve H’s condition. According to the professional neurotherapist here, they recommended H to first take up a 20-session therapy and I decided to give it a shot. I am totally impressed by the result of the treatment as on the 15th session of the therapy, H starts to show positive feedbacks on his tics control. And his condition is remarkably improved after completing the 20th sessions of Brain Trainer.”
“H is now becoming calmer, being able to control his movement and becoming more confident. He is more sociable now and he managed to proceed to his tertiary studies on culinary art. His teacher and friends are very surprised of his improvement. Most importantly, I can see him living happier and more healthily now.”

By H'S MOTHER
Remark: Our client's information will be kept strictly confidential all the time. All reviews and photos have been acknowledged and provided by past and current clients of Spectrum of Life proactive healthcare centre (Clinical Hypnotherapist Hiro Koo). Clients names have been changed to protect their identity.

Friday, July 29, 2016

2nd Asian Neurofeedback Conference 2016




During the 2nd Asia Neurofeedback Conference this year, I speak about Tic disorder and Tourette syndrome management by using Neuro-hypnotherapy and EEG biofeedback. I am really glad to be here today. 
😄
Abstract
This paper discussed EEG biofeedback as a standalone tool or used together with neuro-hypnotherapy approach for Tics and Tourette Syndrome. In this paper, the advantages of EEG biofeedback alone or integrating EEG biofeedback in neuro-hypnotherapy were explained. Four cases of patients with presenting problems related to tics and Tourette syndrome were presented. The protocol and improvement were mentioned and highlighted. 







Speakers of the day




*Special thanks to Miss Tan Wan Yen. Thank you for giving me a hand in doing research.

Thursday, May 26, 2016

妥瑞症醒觉月份National Tourette Syndrome Awareness Month (May 15 – June 15)
























这个五月天,乃是妥瑞症醒觉月份;
虽已来到月末,但并不表示患有相关病症的人士所感受到的痛苦随之流逝而去……

在日常中,你可曾察觉到身边某些人总爱清喉咙?
不自觉地抖动他们的身体?
甚至是忽地发出怪叫的声响?
或许你会认为此等行径是坏习惯的一类,但却未深层地区了解更多……

这,可能正是妥瑞症的症状。一种难以自我控制的症候群。

在工作范畴中,我接触过不少患有此症的群体;
无论是大人或孩子,他们身心上所受的委屈是你我无法想象的。
好比说,最近一位患者来求医时告诉我,他感到极致的难过,原因正是学校中的师长都怪他频密地发出怪声,以致干扰周遭的同学。
而更递进的问题是,当他开口澄清状况之际,师长们会怪他找藉口。
他的内心充满着忧伤的情绪,甚至也想过自残。
他因此不爱上学,脾气也变得相当糟糕。

即便并非病患,你可曾遭遇过相似的情景——努力解释但依旧被误解?雷同的景况若是驾临在自身身上,任何人皆不会好受。
试想象相关病患一直活在师长、朋友与陌生人的团团误解之中,这一番感觉将会如何啃噬你的心境呢?

始于今天,少点批判,多点同理心。


更多关于马来西亚妥瑞症治疗介绍Non-drug therapy for Tics/Tourette syndrome:

http://www.newmindcentre.com/2016/02/non-drug-therapy-for-ticstourette.html

Wednesday, March 2, 2016

Tourette Syndrome Treatment in Malaysia - EEG biofeedback/Neurofeedback

Gilles de la Tourette syndrome (TS) is characterized by motor and vocal tic manifestations, often accompanied by behavioral, cognitive and affective dysfunctions. 

Electroencephalography of patients with TS has revealed reduced Sensorimotor Rhythm (SMR) and excessive fronto-central Theta activity, that presumably underlie motor and cognitive disturbances in TS. 

Some evidence exists that EEG biofeedback or neurofeedback (NFB) training aimed at enhancing SMR amplitude is effective for reducing tics. The present report is an uncontrolled single case study where a NFB training protocol, involving combined SMR uptraining/Theta downtraining was delivered to a 17-year-old male with TS. 

After sixteen SMR-Theta sessions, six additional sessions were administered with SMR uptraining alone. SMR increase was better obtained when SMR uptraining was administered alone, whereas Theta decrease was observed after both trainings.

The patient showed a reduction of tics and affective symptoms, and improvement of cognitive performance after both trainings. 

Overall, these findings suggest that Theta decrease might account for some clinical effects seen in conjunction with SMR uptraining. Future studies should clarify the feasibility of NFB protocols for patients with TS beyond SMR uptraining alone.



Source:
https://www.researchgate.net/publication/51641932_Neurofeedback_Training_for_Tourette_Syndrome_An_Uncontrolled_Single_Case_Study

Saturday, February 20, 2016

马来西亚妥瑞症治疗Non-drug therapy for Tics/Tourette syndrome

妥瑞氏症 (Tourette Syndrome)
妥瑞氏症也稱妥瑞氏綜合症,患者會有不自主重複性動作的癥狀,表現在臉部、手部或腳部可觀察的小肌肉規律性抽動,以及額頭、眼尾、鼻子、嘴部肌肉群的區塊抽動。重症者會出現頭部、頸部、肩膀、身體、腳部的上下前後扭動,以至二個手臂連接整個上半身的大擺動,再結合從小聲至大聲的囈語或穢語。抽動的範圍愈大,時間愈久、次數愈頻繁,顯示癥狀愈為嚴重,反之則癥狀愈為緩解。



妥瑞氏症簡介 妥瑞氏症也稱妥瑞氏綜合症、吐雷氏症、吐雷氏綜合症。此症是法國妥瑞(last nameJean-Nartub Charcot ,first name Gillies de la Tourette)醫生於1885年提出的8個病例報告。此種患童會不自主動作,包括抽搐、眨眼睛、噘嘴巴、裝鬼臉、臉部扭曲、聳肩膀、搖頭晃腦;及不自主出聲,包括清喉嚨、大叫或發類似「干」的怪聲。約有百分之五十的患者會伴有注意力缺陷過動症。

症状 聲語上的抽搐(Vocal Tics) 聲語型抽筋可說是妥瑞氏症最為人所知的癥狀。聲語型抽筋包含廣泛,從單純的清喉嚨,擤鼻涕,發出象豬的咕嚕聲,狗叫聲,到突然說一些詞語或發出無意義的聲音。絕大多數的人以為妥瑞氏症患者會突然口出穢言。事實上,大約只有15%的妥瑞氏症病例會出現這種情形。如同運作型抽筋,聲語型抽筋的嚴重程度是變動的,且形式經常改變(譬如說,從發出象豬的呼嚕聲到說一些話語),癥狀隨著狀況不同時好時壞。 聲語型抽筋可分為簡單型以及複雜型。簡單型聲語抽筋包括發出一些簡單的聲響象是清喉嚨或是擤鼻涕。複雜型的聲語抽筋則包括任何言語,連猥褻的言詞也囊括其中;重複別人的話;或是反覆喃喃自語。

動作上的抽搐(Motor Tics) 動作型抽筋是一些不自主的運動,通常發生於臉和脖子的肌肉。這些不自主的運動包括聳肩,眨眼,以及擤鼻子。當手臂伸展,踢腿或跳躍時,身體其他部位也參與其中。動作型抽筋通常發生於身體的同一部位,但是隨著時間的過去,抽筋的現象可能從一部份消逝而在另一個部位又冒出來。


動作型抽筋可以分為簡單型以及複雜型。 簡單型抽筋是突發的、短暫動作,它通常的發作模式是一次只有單一一個位置的肌肉抽筋。象是眨眼、聳肩或是搖頭晃腦都是簡單型動作抽筋的例子。 複雜型抽筋則是一連串的動作。看起來好象是有目的,象是那個人刻意有那些舉動,但實際上他們是不自主的做了那些動作。 舉例來說,複雜型抽筋可能是聞東西(它包含了把東西拿起來,將物體靠近鼻子,聞一聞,然後放下)或是模仿別人的動作(稱為仿作"echopraxia")。 這些舉動很可能被解釋成是患者刻意作出來的。但有一些複雜型抽筋看起來並非刻意而為,象是反覆的踢腿或是搖頭聳肩。 感覺上或心理上的抽搐 大部分的妥瑞氏症兒童都有出現癥狀的前兆,譬如:眼皮酸而眨眼睛,脖子酸而搖頭聳肩,通常是抽搐前兆。也有單獨的燒灼感、緊繃感、肌肉緊張、疼痛。甚至於覺得別人搔癢而去抓人,也有在心理說粗話或重複說一樣的話妥瑞氏兒童在專心於某一行為時(例如:談鋼琴、看錄像帶、玩電動遊樂器、看漫畫書等)抽搐常會消失,熟睡或酒後多半癥狀也會消失;相反地,壓力疲憊無聊及興奮時,會明顯加重抽搐的頻率與強度。 伴隨癥狀過動、注意力不集中(ADHD)及強迫症。根據葉啟斌醫師的說法約有40%的妥瑞氏症兒童有強迫症。Deputy( 2002)表示:至少有五分之一的妥瑞氏症兒童伴隨有注意力缺陷過動症(ADHD)。 

病因 

過度敏感反應 目前所知的病因是腦基底核的多巴胺過度敏感反應,及腦基底核與腦皮質之間的聯繫出現問題,導致出現慢性、反覆、半不自主的動作及聲語上的抽搐(tic)。約50-70%的妥瑞兒與遺傳有關。 與鏈球菌感染有關 根據國外的研究約有四成的妥瑞氏症兒童與鏈球菌感染有關。妥瑞氏症可能與紅斑性狼瘡一樣,是一種自體免疫疾病,鏈球菌感染是危險因子。有妥瑞氏症家族史及體內B型淋巴結免疫缺損的孩童應盡量避免感染鏈球菌。   感冒對神經傳導物質多巴胺也會有所破壞,造成多巴胺不足而導致妥瑞氏症及帕金森症。

其它環境因素 環境因素如有毒物質、心理興奮劑、過敏原、食品等。


發病人群 妥瑞氏症在所有人種皆可見。 妥瑞氏症的病徵通常在18歲之前出現,在7 歲半左右發作。 男性妥瑞氏症的發生率比女性高三到四倍。

诊断 雖然說並無法使用單一一個測驗即可檢測出一個人是否罹患妥瑞氏症,但是某些檢驗,例如:MRI,CT,EEG 以及血液測試皆可幫助醫師將癥狀與妥瑞氏症類似的疾病排除。假如受檢對象在其他的檢查的結果都是陰性的,而此人長期以來一直有多重的動作型或聲語型抽筋,癥狀持續超過一年以上,則可以做出此人為妥瑞氏症患者之臨床診斷。

治療 妥瑞氏症的心理治療分成二個階段,分別處理癥狀與癥狀造成的影響。
第一階段是抽動動作、行為的矯治,以及腦部異常放電之腦電波心身回饋治療
第二階段是偏差行為矯治、人格重建以及深度心理治療。 父母親的協助以及當事人意志力的激發,是治療妥瑞氏症最重要的助力。若無家屬和患者的全力配合,通常心理治療作業都會中斷無法建構療程與療效。

对于妥瑞症的治疗,Newmindcentre.com的治疗师和医师们提供以下服务:


1) 了解病因:检测环境因素
Nutritional therapy合格的营养咨询师将教导您使用食物保養神經的作用穩定 大腦中有許多神經細胞,靠神經傳導物質當「傳令兵」,幫忙傳達指令,身體各部位一收到訊息,就會有所反應。 神經傳導物質有上百種,其中和情緒、壓力有關的包括多巴胺、正腎上腺素、血清素等。好消息是,一些食物可以增加神經傳導物質的濃度,維持神經的作用穩定,不妨適量攝取。营养咨询师可透过头发重金属检测Hair Tissue Mineral Analysis (HTMA)的方法了解环境因素,对症下药了解身体里超标的有毒物质并改变您的饮食,从而帮助您改善身心状态。重金屬藉由飲食、呼吸或是直接接觸方式進入人體,但重金屬不似其他毒素能在肝臟進行分解代謝後排出體外。相對的,它非常容易囤積在大腦、腎臟等器官,漸進式破壞身體的正常功能。簡單、精確、無侵入性的重金屬檢測幫助您提早發現不正常警訊和預防疾病發生。近代學術研究發現,近頭皮的頭髮所含之元素與體內之元素有密切的相關性,並且有強大的學術支持,這些由頭髮檢測之元素即代表體內的元素含量,其中包括了有毒金屬及營養性元素。因頭髮之分析檢測比血液檢測更加的靈敏,可發揮提早發現不正常警訊及與防疾病之優點。














2) 第一階段治疗:抽動動作、行為的矯治(Habit Reversal Therapy)与腦電波心身回饋治療(EEG biofeedback/Neurofeedback)
我们拥有在马来西亚极少数受过合格脑电波心身回馈治疗与拥有丰富临床经验的治疗师。治疗师除了提供科学,安全无痛又无副作用的脑电波心身回馈治疗,也会教导客户如何使用Habit Reversal Therapy等对抽動動作、行為的矯治疗法。



3)第二階段治疗:偏差行為矯治、人格重建以及深度心理治療(Psychotherapy and Neuro-hypnotherapy)
我们拥有执业临床催眠师,可以透过临床催眠疗法除了可以减轻妥瑞症的症状,也能帮助客户进行偏差行为矫正,情绪与心理治疗以帮助客户进行完善的人格重建。我们所使用的脑电波心身回馈治疗也专门设计了针对客户的智力与情绪进行正面的调整功能。



4) 提供客户的亲属适当的心理建设Psychoeducation 
我们提供父母或亲属适当的心理建设与应对措施,让他们了解如何与病患相处。同时也可以和家属亲人一起探讨对策,帮助病患一起面对来自学校,工作以及社会所给予的压力与不平等对待。




总结,我们治疗的5大特点是:
科学验证疗法,
非侵入性并完全无痛,
安全并无副作用,
完全不使用任何药物,
许多成功减轻病情临床案例






 资料来源: http://www.twwiki.com/wiki/%E5%A6%A5%E7%91%9E%E6%B0%8F%E7%97%87

Wednesday, January 27, 2016

Hypnosis Helps Reduce Symptoms of Tourette Syndrome


Tourette Syndrome is a neurological disorder that is characterized by motor and verbal tics. The symptoms first become apparent in early childhood. The first symptom is usually a facial tic such as eye blinking, grimacing, or nose twitching and these are soon replaced with other motor tics involving the neck, limbs, and trunk. These tics are involuntary and people with the disorder experience involuntary urges to perform motor or verbal activity. Hypnosis has been shown to improve the symptoms of Tourette Syndrome.

Symptoms of Tourette Syndrome range from mild to severe. Severe symptoms include verbal tics such as shouting, barking, grunting, and throat clearing. Verbal tics known as coprolalia consist of the involuntary use of obscene words. Copropraxia is the involuntary action of obscene gestures. Although Tourette's is known for these symptoms, they are severe symptoms and not common of the disorder.

The majority of people with Tourette Syndrome have mild symptoms. Also, people with Tourette Syndrome are more likely to also have Attentional Deficit Disorder, Attentional Deficit/Hyperactivity Disorder, Obsessive Compulsive Disorder, and learning disabilities.

Stressful situations can make symptoms of Tourette Syndrome worsen. Tension and anxiety can also be attributed to worsening the symptoms. Hypnotherapy has been found to improve the symptoms of Tourette Syndrome. 

Hypnosis is a relaxed state of consciousness. This state allows people to be more open to suggestions. When these suggestions deal directly with their symptoms and anxiety, they are able to relax and make these suggestions a part of their life, thus reducing their symptoms. After a few sessions, people with Tourette Syndrome can dramatically improve their overall lifestyle.

A case study was conducted involving an adolescent male with Tourette Syndrome. He was referred to a hypnotherapist from his physician. The male had a total of 9 hypnosis sessions over a 6-month time period. The model used involved a 4-step treatment process including progressive relaxation, finger-tip temperature feedback using a biotic finger band, Spiegel's eye-roll procedure, and imagery.Immediately following treatment and at the 6-month follow-up, he reported minimal to non-existent symptoms. The hypnosis sessions had helped him reduce stress that triggered the symptoms and it helped him regain control of Tourette Syndrome. It was also reported that soon after treatment, the participant in the study applied for the Air Force and passed his entrance examination.

Research and studies have shown that hypnosis is helpful in reducing the symptoms of Tourette Syndrome. This will enable Tourette Syndrome sufferers to lead a more normal lifestyle with fewer tics and interruptions. Hypnosis also gives them more control.

Source: http://www.naturalnews.com/027559_Tourette_syndrome_hypnosis.html#ixzz3ySCb8muB