Musk melons are a powerhouse of health; they are loaded with so many nutrients that they almost seem like the superhero of fruits. They are abundantly available in the summers and have a super high percentage of water content in them making them cooling and hydrating. So as the summer approaches, know why you should eat more muskmelons. They not only have a delicious aroma but they also taste amazing. Their seeds contain many health benefits as well.
The nutrition breakdown of 1 cup of musk melons is given below:
Calories: 53 Fat: 0 g (yes, read that as ZERO) Saturated Fat: N/A Cholesterol: 0 mg (ZERO again!) Carbohydrate: 12 g Protein: 1 g Dietary Fibre: 1 g Sodium: 23 mg Vitamin A: 5,276 IU Folic Acid: 33 micrograms Niacin: 1 mg Vitamin B6: <1 mg Vitamin C: 57 mg Calcium: 14 mg Magnesium: 19 mg Potassium: 417 mg Carotenoids: 3,219 micrograms
Here are the amazing health benefits of musk melon…
Controls blood pressure
Muskmelons are rich in potassium which helps in regulating the blood pressure and keeps hypertension at bay.
Strengthens eyes
They have high doses of vitamin A and beta carotene, which helps sharpen the eye sight as well as reduce the risk of developing cataracts.
Helps in weight loss
Musk melons have negligible fat content in them. They also contain the good carbohydrates derived from sugars which are easily broken down by the body. Their water content is also very high. Their seeds contain a special fibre in them which helps in losing weight. They contain really high content of potassium which helps in losing belly fat.
Helps control diabetes
Muskmelons help regulate the blood sugar levels thereby helping control diabetes.
Low on cholesterol
They are absolutely cholesterol free and hence can be had without any worry.
Boosts immunity
Musk melons are super rich in vitamin C, they strengthen the immune system. They stimulate and increase the white blood cells which help in destroying viruses and bacteria. They also prevent premature ageing of cells. Learn about building immunity.
Treats ulcers
The high quantity of vitamin C helps in treatment and also prevention of ulcers.
Relieves constipation
Musk melon contains a significant amount of dietary fibre, making it good for those suffering from constipation as it add bulk to your diet.
Prevents kidney stones
An extract of musk melon called oxykine has proven qualities of curing kidney disorders and stones. It also cleanses the kidneys owing to its high water content.
Helps during pregnancy
They have high folate content which prevents water retention by removing excess sodium from the body.
Cures sleeping disorder
Musk melons relax the nerves and the muscles making it easier for people with insomnia to sleep.
Eases menstrual cramps
Due to its anti-coagulant property it dissolves clots and eases muscle cramps.
Prevents risk of cancer
The vitamin C eliminates free radicals thereby saving the cells of the body from getting damaged by them, thereby preventing the risk of getting cancer
Helps in quitting smoking
It rejuvenates the lungs and helps the body recover from nicotine withdrawal faster.
Prevents heart diseases
The adenosine in musk melons has blood thinning properties which automatically reduces the risk of heart ailments.
Ultrasound scans are now proving handy to assess bone mineral density and determine if you are at risk for osteoporosis. Globally, the International Osteoporosis Foundation (IOF) estimates that the condition causes about nine million fractures a year, most commonly to the hip, spine and wrist. Bone loss also has a serious impact on a person’s health and quality of life. In some cases, it can even lead to long-term disability and death. The disease can also be a high socioeconomic burden, in terms of medical costs and loss of work days.
A new study, published in The Journal of the American Osteopathic Association, suggests that data from ultrasound bone tests are as good as dual-energy X-ray absorptiometry (DEXA) to assess bone mineral density.
DEXA remains an excellent option as it uses a very small dose of ionising radiation to obtain pictures of the spine and hips to measure bone loss. But it is expensive and many people may not be able to afford it. Ultrasound, by contrast, is portable, inexpensive and involves no radiation. It measures how sound waves move through the bone. The IOF claims about 80 per cent of people at high risk of osteoporosis still remain under-diagnosed even after they have had one fracture.
Skeleton Key
Thinning of bones, or osteopenia, advances with age. Over time, it can lead to injury. You can help halt it by:
Eating vegetables rich in vitamin C, which stimulates production of bone-forming cells Strength training, especially those who suffer joint deficiencies in the lower extremities such as arthritis in the knee/ hip Adding a daily vitamin D supplement to help absorb calcium Doing high-impact weight-bearing exercises. These are best for building bones, if you have been diagnosed with osteopenia or osteoporosis Getting bone mineral density tested so that orthopaedic specialists can get a quick and painless snapshot of bone health Considering medication as calcium and vitamin D can serve as building blocks; Quitting smoking and excessive drinking Survival of the Fattest
Obese? Worry not. You may have a lower chance of dying following a stroke than someone with a normal Body Mass Index (BMI). So claims Dr Zuolu Liu of the University of California, Los Angeles, and her team, as they presented their findings to the American Academy of Neurology. Overall, people with severe obesity had a 62 per cent lower chance of dying from a stroke; people with obesity, 46 per cent; and the overweight 15 per cent. However, the underweight had a 67 per cent higher chance of dying of a stroke. A possible explanation is that overweight or obese people may have a nutritional reserve that may help them survive during prolonged illness, says Liu. But more research is needed to investigate the relationship between BMI and stroke.
Make Your Hobby Work
Hobbies are fun but you can also make them work for you. The fulfilling, productive use of free time boosts your health. Here’s how:
Dancing: It’s a workout like no other that improves cardiovascular health, builds stamina, strengthens bones and muscles Gardening: Pulling out weeds, planting and usage of tools are a subtle form of aerobic exercise and help improve flexibility Writing: Seemingly sedentary, the activity helps enhance mental and physical well-being, improves memory, reduces stress levels and ensures good sleep Listening to music: It boosts the body’s immune system, lowers anxiety levels and eases depression Adopting a pet: Pushes you outdoors, provides socialising opportunities, improving physical and emotional health.
00seshunarayanahttps://imedworks.com/wp-content/uploads/2020/09/MedWorks-Logo-02-300x300.pngseshunarayana2020-07-20 14:24:252020-07-20 14:24:25All about bones
These days acidity and heart burn are more common in people. There are many things which causes acidity in human body. People who drink bed coffee/ tea or those who drink tea/coffee multiple times a day like more than 4 – 5 times. Drinking alcohol regularly, skipping meals can cause acidity. Spicy food, fast food with masala etc can also cause acidity.
GERD ( Gastroesophageal Reflux Disease) affects millions of people each day and is a more serious form of acid reflux. It is the most common digestive disorder in the United States. In fact, Americans alone spend more than $15 billion on acid blocking medications each year.
It is possible that you have found some relief from your condition by using over-the-counter pills or even some prescription medication. The problem with either of these options is that they don’t address the root of the issue, they only cover up the symptoms.
Although it seems like acid reflux and GERD or the “burn” as you may describe it, is the result of too much acid, it is the result of too little acid. That’s right, an interesting point supporting this theory is both heartburn and GERD increase as we age, however, the amount of stomach acid that we have decreases.
Dr. Jonathan Wright, MD of the Tahoma Clinic in Washington state found that people who are suffering from heartburn and GERD have low, not high, stomach acid. In fact, in all of Wright’s twenty-five years of observation, he very rarely ever saw anyone with too much acid. Now, you may ask if heartburn and GERD are the results of too little acid, why do antacid medications take away the uncomfortable symptoms? It is important to understand that what causes the burn is stomach acid refluxing into the esophagus. Any amount of acid in the esophagus will cause discomfort because it is not designed to protect from this. You don’t have to have too much acid to cause the reflux or the pain – any amount will do this.
Simply taking an antacid will not get to the root of the problem, it is only suppressing a symptom of the larger issue. Western medicine is notorious for doing this – suppressing a symptom without dealing with the larger problem at hand.
GERD is caused by an increase in pressure of the intra-abdominal area. Reflux happens with the pressure causes bloating that pushes the contents of the stomach (including acid) through the LES (lower esophageal sphincter ) into the esophagus. There are many factors that contribute to this including, overeating, obesity, bending over after eating, lying down after eating and eating spicy or fatty food
Following food gives relief to acidity: 1. Bananas. This low-acid fruit can help those with acid reflux by coating an irritated esophageal lining and thereby helping to combat discomfort. Due to their high-fiber content, bananas also can help strengthen your digestive system — which can help ward off indigestion. One soluble fiber found in bananas is pectin, which helps move stomach contents through your digestive tract. And that’s a good thing — because food that sticks around will only continue to generate acid.
2. Melons. Like bananas, melons also are a highly alkaline fruit. They are a good source of magnesium, which is found in many medicines for acid reflux. Furthermore, melons have a pH of 6.1, making them only mildly acidic. Especially good are cantaloupe and honeydew melon.
3. Oatmeal. Like other high-fiber foods, oatmeal may help stave off acid reflux symptoms. Fiber not only promotes intestinal health, but it also reduces constipation and makes you feel full a long while after eating it. And, of course, when you feel full, you are less likely to overeat and therefore less likely to regurgitate what’s in your stomach into your esophagus. Enjoy your oatmeal with low-fat or almond milk, as both are low in fat and highly alkaline.
4. Yogurt. Like bananas, yogurt has a soothing effect that helps keep stomach discomfort at bay. It also contains probiotics, a type of good bacteria found in the digestive tract that gives a boost to your immune system. Being a good protein source means yogurt also improves your ability to properly digest food. Make yogurt even more impactful by adding in a bit of ginger, which can act as an anti-inflammatory in your system.
5. Green Vegetables. If you like green vegetables and have acid reflux, you’re in luck. Asparagus, spinach, kale and brussels sprouts all are highly alkaline, meaning they’re good for your stomach and digestive system. Being naturally low in fat and sugar, vegetables also help lessen stomach acid.
Vertigo is a sensation of feeling off balance. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning.
Causes of Vertigo Vertigo is often caused by an inner ear problem. Some of the most common causes include:
BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance.
BPPV can occur for no known reason and may be associated with age.
Meniere’s disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss.
Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance
Less often vertigo may be associated with:
Head or neck injury Brain problems such as stroke or tumor Certain medications that cause ear damage Migraine headaches
Symptoms of Vertigo Vertigo is often triggered by a change in the position of your head.
People with vertigo typically describe it as feeling like they are:
Spinning Tilting Swaying Unbalanced Pulled to one direction Other symptoms that may accompany vertigo include:
Feeling nauseated Vomiting Abnormal or jerking eye movements (nystagmus) Headache Sweating Ringing in the ears or hearing loss Symptoms can last a few minutes to a few hours or more and may come and go.
Treatment for Vertigo Treatment for vertigo depends on what’s causing it. In many cases, vertigo goes away without any treatment. This is because your brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance.
For some, treatment is needed and may include:
Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the vestibular system. The function of the vestibular system is to send signals to the brain about head and body movements relative to gravity.
Canalith repositioning maneuvers. Guidelines from the American Academy of Neurology recommend a series of specific head and body movements for BPPV. The movements are done to move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by the body. You will likely have vertigo symptoms during the procedure as the canaliths move. A doctor or physical therapist can guide you through the movements. The movements are safe and often effective.
Medicine. In some cases, medication may be given to relieve symptoms such as nausea or motion sickness associated with vertigo.
If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection. For Meniere’s disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup.
Surgery. In a few cases, surgery may be needed for vertigo. If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment for those problems may help to alleviate the vertigo.
Fibromyalgia is often called an invisible disease. There’s no specific test to diagnose it, and it can be puzzling to a doctor who’s not familiar with the condition. The symptoms overlap with many other illnesses, so it’s possible to be misdiagnosed.
Don’t be discouraged if you need to see a few different doctors. A specialist may be in a better position to understand what’s going on with you and create a treatment plan that eases your symptoms and helps you feel better.
What to Look For First, you want someone who will take you seriously. Your doctor needs to believe your pain, fatigue, and thinking problems are real and be willing to try to do something about them.
Because your treatment may involve more than one health care professional, you’ll also want a doctor who is well-versed in the complex world of fibromyalgia to oversee it all: medication, physical therapy, nutrition, acupuncture, sleep management, and biofeedback, for example.
People with fibro often have other ailments, too, including irritable bowel syndrome, headaches, and jaw pain. Your doctor should know how to deal with these, or work well with another provider who can care for you.
Primary Care Doctor Not all general internists or family doctors are familiar with fibromyalgia. But if yours is and has treated others with the condition, they may be the one to spearhead your treatment.
Rheumatologist These doctors specialize in musculoskeletal and autoimmune diseases, such as arthritis and gout. Though fibromyalgia isn’t a form of arthritis and doesn’t cause inflammation or damage to joints, muscles, or other tissues, the symptoms someone with fibro feels are similar.
Rheumatologists often coordinate the types of care you’ll need, so one could be your top choice for fibro treatment.
Pain Medicine Specialist They come from a variety of fields, including internal medicine, neurology, orthopedic surgery, and psychiatry. A pain clinic may also have a team of physical therapists, nurses, and occupational therapists on staff to help treat your overall symptoms.
Symptoms If you have fibromyalgia, one of the main symptoms is likely to be as follows:
A bone marrow transplant is a treatment that replaces unhealthy marrow with a healthy one. It’s also called a blood or marrow transplant.
What is bone marrow? Bone marrow is the soft, spongy tissue inside your bones that makes blood-forming cells (blood stem cells). These cells turn into blood cells including White Blood cells to fight infection. Red blood cells to carry oxygen throughout the body. Platelets to control bleeding.
How does transplant work?
Before transplant, you get chemotherapy (chemo) with or without radiation to destroy the diseased blood-forming cells and marrow. Then, healthy cells are given to you. The new cells go into your bloodstream through an intravenous (IV) line, or tube. It’s just like getting blood or medicine through an IV. The cells find their way into your marrow, where they grow and start to make healthy red blood cells, white blood cells and platelets.
Bone marrow transplants can treat:
Blood cancers like leukemia or lymphoma Bone marrow diseases like aplastic anemia Other immune system or genetic diseases like sickle cell diseases.
Read more about the 3 common types of BMT: Autologous transplant – uses your own blood-forming cells Allogeneic transplant – uses blood-forming cells donated by someone else.
Bone marrow donation is done under general or regional anesthesia so the donor experiences no pain during the donation procedure. Discomfort and side effects after the donation vary from person to person. Most marrow donors experience some side effects like back or hip pain.
The predicted rate of survival was 62 percent. In allogeneic bone marrow transplantation, a person’s blood-forming stem cells are eliminated and then replaced with new, healthy ones obtained from a donor or from donated umbilical cord blood.
Marrow Donation: Marrow is taken through a needle placed into the donor’s pelvic (hip) bone while the patient is under anesthesia. The procedure is performed in a hospital operating room and takes 1 to 2 hours. Donors typically give about 2 to 3 percent of their marrow, which grows back within a few weeks.
00seshunarayanahttps://imedworks.com/wp-content/uploads/2020/09/MedWorks-Logo-02-300x300.pngseshunarayana2020-07-20 14:04:262020-07-20 14:04:26What is Bone Marrow Transplant?
In most cases, prostate cancer symptoms are not apparent in the early stages of the disease. The symptoms of prostate cancer may be different for each man, and any one of these symptoms may be caused by other conditions. As a result, routine screenings in the form of digital rectal exams and prostate-specific androgen (PSA) tests are important.
Early warning signs of prostate cancer Because of the proximity of the prostate gland to the bladder and urethra, prostate cancer may be accompanied by a variety of urinary symptoms, especially in the early stages. Depending on its size and location, a tumor may press on and constrict the urethra, inhibiting the flow of urine. Some early prostate cancer signs include:
Burning or pain during urination Difficulty urinating, or trouble starting and stopping while urinating More frequent urges to urinate at night Loss of bladder control Decreased flow or velocity of urine stream Blood in urine (hematuria) Blood in semen Difficulty getting an erection (erectile dysfunction) Painful ejaculation Prostate cancer may spread (metastasize) and form tumors in nearby organs or bones. If the cancer spreads to the spine, it may press on the spinal nerves. Signs of metastatic prostate cancer may include:
Swelling in legs or pelvic area Numbness or pain in the hips, legs or feet Bone pain that doesn’t go away, or leads to fractures The symptoms of prostate cancer often differ from patient to patient. The most common first sign of recurrent prostate cancer is a rise in the PSA level in the blood, making regular PSA tests all the more important in measuring the progress of treatment and checking for signs of recurrence. It is important to report new signs or symptoms to your doctor. Prostate specific antigen test A prostate-specific antigen (PSA) test measures the level of PSA in the blood. The prostate gland produces PSA, a protein that at an elevated level may be a sign of prostate cancer. A high PSA reading also may indicate noncancerous conditions such as inflammation of the prostate (prostatitis) and enlargement of the prostate (benign prostatic hyperplasia).
Men who have symptoms associated with prostate cancer may have a PSA test along with a digital rectum exam (DRE). These symptoms include burning or pain during urination, loss of bladder control, painful ejaculation, and swelling in legs or pelvic area. For the test, a clinician takes a sample of your blood and sends it to a lab for analysis.
In the past, a PSA reading of 4 ng/mL and below was considered normal. Men with a reading above 4 ng/mL were considered likely to have prostate cancer and would have a biopsy to confirm the cancer’s presence. According to the National Cancer Institute, research has found that men with prostate cancer can have a low PSA level, while men without prostate cancer can have a high level. One in four men with an elevated PSA level actually has prostate cancer. However, an increase in PSA level over time may indicate a prostate tumor.
The American Cancer Society recommends that men make an informed decision with their doctor about whether to be tested for prostate cancer, beginning at age 50. Men with one or more risk factors for prostate cancer should consult with their physician about whether to start routine screening earlier. Symptoms of enlarged prostate can include: A weak or slow urinary stream. A feeling of incomplete bladder emptying. Difficulty starting urination. Frequent urination. Urgency to urinate. Getting up frequently at night to urinate. A urinary stream that starts and stops. Straining to urinate.
00seshunarayanahttps://imedworks.com/wp-content/uploads/2020/09/MedWorks-Logo-02-300x300.pngseshunarayana2020-07-20 13:57:322020-07-20 13:57:32Prostate Cancer Symptoms..
Some people say they don’t eat much skip meals still they are fat. If water stays in the body, doesn’t go out in the form of sweat, tears or urine, it gets stored in stomuch, liver, kidney and intestine. When this dirty water doesn’t get out, tummy, face, waist looks fat. If water gets stored in stonuch like this, its called ascites. If water is stored in lungs, its called Pulmonary Edema. When body starts storing water, it happens in two ways. Water can be stored in all parts of the body or it can be stored in one area.
First face looks fat. Then patients can see swelling in legs and hands, tummy, neck and chin areas will look fat. To findout if water stored in stomuch, press your tummy. If you hear the sound, you have excess water in the body. If water in lungs, patient feels little difficulty in breathing and tiredness all the time. Ancient Indian Ayurveda has good home remedy for this problem. Drink butter milk everyday, use Ghee(melted liquid butter), Honey, Jaggery. Barley grains can be cooked and mix drained water in butter milk and drink everyday for relief from excess water. Also use Jaggery, Ghee HOney in everyday diet.
Mix half spoon honey in a cup of hot/ warm water every morning and drink before breakfast in empty stomuch.
Jaggery can be eaten with water or milk. It helps clear water, flem from lungs and also gives good night sleep wneh taken with warm milk at night, after dinner.
If exess water is in legs and thigh, don’t sit for a long time. Walk as much as possible or stand. While sleeping keep 2 -3 pollows under your legs, so water will not store in the legs. And weating honey, jaggery, barley, butter milk will reduce the quantity of water eventually.
00seshunarayanahttps://imedworks.com/wp-content/uploads/2020/09/MedWorks-Logo-02-300x300.pngseshunarayana2020-07-20 13:49:292020-07-20 13:49:29Water retention in body
Asthma: The airways are persistently inflamed, and may occasionally spasm, causing wheezing and shortness of breath. Allergies, infections, or pollution can trigger asthma’s symptoms. Chronic obstructive pulmonary disease (COPD): Lung conditions defined by an inability to exhale normally, which causes difficulty breathing. Chronic bronchitis: A form of COPD characterized by a chronic productive cough. Emphysema: Lung damage allows air to be trapped in the lungs in this form of COPD. Difficulty blowing air out is its hallmark. Acute bronchitis: A sudden infection of the airways, usually by a virus. Cystic fibrosis: A genetic condition causing poor clearance of mucus from the bronchi. The accumulated mucus results in repeated lung infections. Lung Diseases Affecting the Air Sacs (Alveoli) The airways eventually branch into tiny tubes (bronchioles) that dead-end into clusters of air sacs called alveoli. These air sacs make up most of the lung tissue. Lung diseases affecting the alveoli include:
Pneumonia: An infection of the alveoli, usually by bacteria. Tuberculosis: A slowly progressive pneumonia caused by the bacteria Mycobacterium tuberculosis. Emphysema results from damage to the fragile connections between alveoli. Smoking is the usual cause. (Emphysema also limits airflow, affecting the airways as well.) Pulmonary edema: Fluid leaks out of the small blood vessels of the lung into the air sacs and the surrounding area. One form is caused by heart failure and back pressure in the lungs’ blood vessels; in another form, direct injury to the lung causes the leak of fluid. Lung cancer has many forms, and may develop in any part of the lungs. Most often this is in the main part of the lung, in or near the air sacs. The type, location, and spread of lung cancer determines the treatment options. Acute respiratory distress syndrome (ARDS): Severe, sudden injury to the lungs caused by a serious illness. Life support with mechanical ventilation is usually needed to survive until the lungs recover. Pneumoconiosis: A category of conditions caused by the inhalation of a substance that injures the lungs. Examples include black lung disease from inhaled coal dust and asbestosis from inhaled asbestos dust. Lung Diseases Affecting the Interstitium The interstitium is the microscopically thin, delicate lining between the lungs’ air sacs (alveoli). Tiny blood vessels run through the interstitium and allow gas exchange between the alveoli and the blood. Various lung diseases affect the interstitium:
Interstitial lung disease (ILD): A broad collection of lung conditions affecting the interstitium. Sarcoidosis, idiopathic pulmonary fibrosis, and autoimmune disease are among the many types of ILD. Pneumonias and pulmonary edemas can also affect the interstitium. Lung Diseases Affecting Blood Vessels The right side of the heart receives low-oxygen blood from the veins. It pumps blood into the lungs through the pulmonary arteries. These blood vessels can suffer from disease, as well.
Pulmonary embolism (PE): A blood clot (usually in a deep leg vein, deep vein thrombosis) breaks off, travels to the heart, and is pumped into the lungs. The clot lodges in a pulmonary artery, often causing shortness of breath and low blood oxygen levels. Pulmonary hypertension: Various conditions can lead to high blood pressure in the pulmonary arteries. This can cause shortness of breath and chest pain. When no cause is identified, the condition is called idiopathic pulmonary arterial hypertension.
Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood. What are the symptoms? Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering socially inappropriate words such as swearing) or echolalia (repeating the words or phrases of others). However, coprolalia is only present in a small number (10 to 15 percent) of individuals with TS. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished. What is the course of TS? Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10-15 percent of those affected have a progressive or disabling course that lasts into adulthood. What causes TS? Although the cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equally complex.
How is TS treated? Because tic symptoms often do not cause impairment, the majority of people with TS require no medication for tic suppression. However, effective medications are available for those whose symptoms interfere with functioning. Neuroleptics (drugs that may be used to treat psychotic and non-psychotic disorders) are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide).
Unfortunately, there is no one medication that is helpful to all people with TS, nor does any medication completely eliminate symptoms. In addition, all medications have side effects. Many neuroleptic side effects can be managed by initiating treatment slowly and reducing the dose when side effects occur. The most common side effects of neuroleptics include sedation, weight gain, and cognitive dulling. Neurological side effects such as tremor, dystonic reactions (twisting movements or postures), parkinsonian-like symptoms, and other dyskinetic (involuntary) movements are less common and are readily managed with dose reduction.
Discontinuing neuroleptics after long-term use must be done slowly to avoid rebound increases in tics and withdrawal dyskinesias. One form of dyskinesia called tardive dyskinesia is a movement disorder distinct from TS that may result from the chronic use of neuroleptics. The risk of this side effect can be reduced by using lower doses of neuroleptics for shorter periods of time.
Other medications may also be useful for reducing tic severity, but most have not been as extensively studied or shown to be as consistently useful as neuroleptics. Additional medications with demonstrated efficacy include alpha-adrenergic agonists such as clonidine and guanfacine. These medications are used primarily for hypertension but are also used in the treatment of tics. The most common side effect from these medications that precludes their use is sedation. However, given the lower side effect risk associated with these medications, they are often used as first-line agents before proceeding to treatment with neuroleptics.
Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with TS. Recent research shows that stimulant medications such as methylphenidate and dextroamphetamine can lessen ADHD symptoms in people with TS without causing tics to become more severe. However, the product labeling for stimulants currently contraindicates the use of these drugs in children with tics/TS and those with a family history of tics. Scientists hope that future studies will include a thorough discussion of the risks and benefits of stimulants in those with TS or a family history of TS and will clarify this issue. For obsessive-compulsive symptoms that significantly disrupt daily functioning, the serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) have been proven effective in some patients.
