認識妥瑞症及其處理方式

Recognition and Management of Tourette Syndrome

妥瑞症(Tourette Syndrome)是一種於兒童時期出現聲音或動作抽動(tic)的慢性異常。妥瑞症抽動的情形可能一天數次，甚至一分鐘內數十次。這樣突然的、快速的、簡短的聲音或動作，可能造成妥瑞兒日常生活上的困擾、因別人異樣眼光而引起的社交障礙，久而久之，憤怒、憂鬱、低自尊的情形伴隨而來。此外，在台灣，妥瑞症仍屬於一個較陌生的疾病，使得妥瑞兒延誤診斷，甚至被他人誤解、用處罰的方式對待，讓身、心、社會壓力更加明顯。因此，本文將對妥瑞症症狀與診斷、妥瑞症的共病症、預後與分類、治療方式、因抽動影響學習情況、以及人際互動上的壓力，最後，將介紹妥瑞兒在家庭、學校、面對陌生人的處理方式。期望本文可以提供臨床護理人員認識妥瑞症，並在照護或諮詢妥瑞兒及家庭時作參考。

Tourette syndrome (TS) is a chronic tic disorder that occurs in childhood. Children with TS may have multiple tic incidents during a day, even many times per minute. Such sudden, rapid and short utterings or movements may influence sufferers' ability to perform daily activities and present barriers to normal interaction with others. Anger, depression and low self-esteem are commonly seen in many children with TS. Awareness of TS is not great in Taiwan, and so many pediatric patients fail to obtain an early diagnosis and/or are mistreated or punished due to disorder-related behaviors. Such results in elevated physical, psychological and social stresses for sufferers. In this paper, we briefly introduce TS symptoms, diagnosis, classification, prognosis, co-morbidity, related psycho-social stresses, and common treatments. In order to facilitate the effective management of TS, we provide suggestion for patient families and schools as well as recommendations on how to interact effectively with others. We hope this article is helpful for healthcare workers, patients, families and schools to improve the recognition and management of TS.