torrett syndrome

torrett syndrome kinwa torrett syndrome (tii. ess. kinwa torrett syndrome mhanoon sankshipt) haah eka samanya neurodevelopmental disorder aahe joou balpanat kinwa paugandavasthet suru hoto. heey anek halchalinche (motor) sankochan aanee kiman eka swar (dhwanik) sankochan dware darshavile jaate. dolhe mitane, khokala, ghasa saaf karane, soonghane aanee mitane halchali heey samanya tras aahet. hyachya aadhi samanyatah prabhavit snayunmadhye avanchhit ichcha kinwa sanvedana asate, jyala purvasoochana ichcha mhanoon olakhale jaate, kahivela tatpurati dadapali jaau shakate aanee sthan, samarthya aanee varanvartemadhye vaishishtyapurn badal hoto. torrett heey tick vikaranchya varnpatatil adhik gambhir tokavar aahe. samanya nirikshakanchya najaret sahasa yaa aakadyanchi nond nasate.
torrett heey ekekali eka durmil aanee vichitra lakshansamuchchay manale jaat hote aanee lokpriyapane coprolalia (ashleel shabdanche uchcharan kinwa samajikdrushtya ayogya aanee apmanaspad tippanya) shhee sambandhit aahe. heey aata durmil manale jaat nahee; jaree koprolaliya keval alpasankhyakanmadhye hoto, taree shaley vayatil sumare 1 takke mule aanee paugandavasthetil mulanna torrets asalyacha andaj aahe. torretchya nidanasathi konatyahi vishisht chachanya naheet; tee nehmich yogyaritya olakhali jaat nahee, kaaran bahutek prakarane saumya asatat aanee bahutek mulanmadhye kishoravayin vayatoon jaat asatana aakadichi tivrata qamee hote. tyamule, anekanche nidan hott nahee kinwa teey kadhihi vaidyakeey madat gheu shakat naheet. praudhavasthetil torret heey jaree prasarmadhyamandhye khalbaljanak asale taree durmil aahe, parantu alpasankhyakansathi, gambhirpane durbal karnare aakunchan praudhavastheparyant tiku shakate. torretcha buddhimatta kinwa aayurmanavar parinam hott nahee.
torretwar konatahi upchar nahee aanee ekahi sarvat prabhavi aushadh nahee. bahutansh prakarananmadhye, aakadisathi aushadhe aavashyak nasatat aanee vartanukivaril upchar heey pahilya kramankache upchar asatat. shikshan haah konatyahi upchar yojanecha eka mahattvacha bhag aahe aanee keval spashtikaranamulech itar konatyahi upcharachi aavashyakta nahee yachee pureshi khatri milate. turate asalelya vyaktinchya vyapak loksankhyepeksha jyanna vishesh chikitsalayanmadhye pathavale jaate, tyanchyamadhye attension deficit hyperactivity disorder (aii. dii. etch. dii.) aanee obsessive-compulsive disorder (oo. see. dii.) yasarkhya itar paristhiti asanyachi shakyata jaast asate. yaa abhyasanmadhye paristhitimule anekada vyaktila aakadipeksha adhik ashaktapana yeto; mhanoon abhyasanmadhye paristhitinmadhye yogya farak karane aanee tyanchyavar upchar karane mahatvache aahe.
french neurologist jeane-martin charkot yanni george gills day laa torrett yaa tyanchya prashikshanarthisathi torrett syndromeche naav dile, jyanni 1885 madhye 'aakunchansheel tick vikar' asalelya nauu rugnancha ahwal prakashit keela. achook kaaran adnyat asale taree, tyat anuvanshik aanee paryavaraniy ghatakanche sanyojan samavisht asalyache manale jaate. yaa yantranet besal ganglia aanee mendutil sambandhit sanrachananmadhil majjatantu paripathanmadhye karyaheenata samavisht asalyache disate.
vargikaran.
torrett syndromeveril bahutek prakashit sanshodhan americet udbhavate; aantarrashtriy tii. ess. sanshodhan aanee vaidyakeey vyavharat, jaagtik aarogya sanstha (kona) vargikaranapeksha 'mansik vikaranche nidan aanee sankhyikeey niyamavali' (dii. ess. emm.) laa pradhanya dile jaate, jyavar 2021 chya 'european clinical margdarshak tattvanmadhye teeka kelee aahe.
2013 madhye prakashit jhalelya dii. ess. emm. (dii. ess. emm.-5) chya pachvya aavruttit, torrett syndromeche eka motor vikar (majjasansthecha eka vikar joou asamanya aanee anaichhik halchalinna karanibhoot tharato) mhanoon vargikaran kele gele aahe. heey neurodevelopmental disorder shreneet soochibaddha aahe. torrett heey tick vikaranchya varnpatatil adhik gambhir tokavar aahe; tyachya nidanasathi eka varshapeksha jaast kaal anek motor tick aanee kiman eka vocal tick asane aavashyak aahe. aakadi mhanje achanak, punaravrutti honari, gair-laybaddh halchal jyamadhye swatantra snayu gatancha samavesh asato, tarr swar (dhwanik) aakadimadhye aavaj nirman karnyasathi swarayantra, swarayantra, tond, anunasik kinwa shwasan snayu asatat. itar vaidyakeey paristhiti kinwa madak padarthanchya vaparadvare yaa aakunchananche spashtikaran dile jaau naye.
itar tick vikaranmadhye satat (junat) motor kinwa vocal tikcha samavesh hoto, jyamadhye eka prakarcha tick (motor kinwa vocal, parantu donhi nahee) eka varshapeksha jaast kalapasoon astitvat aahe; aanee tatpurata tick disorder, jyamadhye motor kinwa vocal tick eka varshapeksha qamee kalapasoon astitvat aahet. dii. ess. emm. chya pachvya aavruttine jyala 'kshanik tick vikar' mhatale gele hote tyala 'tatpurata tick vikar' asey badaloon, 'kshanik' heey keval mage valoon pahile jaau shakate heey olakhale. kahee tadnyanche asey mutt aahe qee tii. ess. aanee satatcha (dirghakalin) motor kinwa vocal tick disorder hii samaan sthitee manali pahije, kaaran vocal tick dekhil yaa arthane motor tick aahet qee teey anunasik kinwa shwasan snayunche snayu aakunchan aahet.
torrett syndromechi vyakhya fakt thodya vegalya paddhatine konadvare kelee jaate; tyachya icd-11 madhye, rog aanee sambandhit aarogya samasyanche aantarrashtriy sankhyikeey vargikaran, torrett syndromeche vargikaran majjasansthecha rog aanee neurodevelopmental disorder mhanoon kele jaate aanee nidanasathi fakt eka motor tick aavashyak aahe. aay. see. dii. chya junya aavruttyanni tyala "combined vocal andd multiple motor tick disorder [dii laa touret]" asey mhatale.
anuvanshik abhyas asey soochit karatat qee tick vikaranmadhye asha varnpatancha samavesh hoto joou sadhyachya nidanatmak chaukatitil spasht-bhedandware olakhala jaat nahee. 2008 pasoon, abhyasanni asey suchavale aahe qee vidyaman vargikaran pranalinmadhye varnan kelyapramane, torrett hii eka vishisht yantrana asaleli ekatmak sthitee nahee. tyaeivaji, abhyas asey suchavatat qee, 'shuddha tii. ess.' aanee 'tii. ess.' madhye farak karnyasathi upprakar olakhale pahijet, jeey laksh qamee atee sakriyata vikar (aii. dii. etch. dii.), obsessive-compulsive disorder (oo. see. dii.) kinwa itar vikaransah asatat, jyaa prakare upprakar sthapit kele gele aahet, jase qee prakar 1 aanee prakar 2 madhumeh yasarkhya itar paristhitinsathi. yaa upprakaranche spashtikaran heey aanuvanshik aanee tick vikaranchya itar karananchya purn samajutichi pratiksha karate.
vaishishtye.
ticks.
samanya halchalinchya parshvabhumivar' adhunmadhun aanee anpekshitpane anpekshitpane halchali kinwa aavajanna 'samanya vartane chukichya jhalya' asey disate. torretchya menacha aanee ksheen honyashi sambandhit aakunchan; teey sankhya, varanvarta, tivrata, sharirik sthan aanee guntaguntimadhye badaltat; pratyek vyaktila tyanchi tivrata aanee varanvartemadhye chadh-utarancha eka anokha namuna anubhavato. bout auph bout' madhye dekhil aakadi yeu shakatat, jeey lokanmadhye dekhil badaltat. tikchya tivratetil farak taas, divas kinwa aathvadyanmadhye houu shakato. jevha konee tanav, thakwa, chinta kinwa aajarpan anubhavat asel kinwa tv pahanyasarkhya aaramdayi upkramanmadhye guntalele asel tevha taana vadhu shakato. jevha ekhadi vyakti vadye vajavanyasarkhya karyat guntaleli asate kinwa tyavar laksh kendrit karate tevha tee kadhikadhi qamee hotat.
itar halchalinchya vikaranshi sambandhit asamanya halchalinchya ulat, torretchya aakunchan heey layheen asatat, bahutekda avanchhit ichchepurvi asatat aanee tatpurte dadapanyayogya asatat. kalantarane, torrett asalelya sumare 90 takke vyaktinna khokalyapurvi khaaj yenyachya kinwa khaaj yenyachya ichchesarkhich ichcha jaanavate. tikchya abhivyaktipurvichya ichcha aanee sanvedananna purvasanvedi sanvedanatmak ghatana kinwa purvasanvedi ichcha mhanoon sambodhale jaate. lock hii vasna vyakt karnyachya ichcheche varnan tanav, dabav kinwa urjechi ubharani mhanoon karatat, jee shevati mukt karnyasathi janivpurvak nivadatat, janoo tyanna sanvedana qamee karnyasathi kinwa tee 'agadi yogya' vatnyaparyant 'teey karave lagale. yaa aagrahamule parinami kalat tikshi sambandhit sharirachya bhagat trasdayak sanvedana houu shakate; tick haah eka pratisad aahe joou tikchya sharirik sthanavaril aagrah door karato. yaa ichchhechi udaharane mhanje aekhadyachya ghashat kahitari asalyachi bhavna, jyamule aekhadyacha ghasa swachchh karnyasathi eka aakunchan yete kinwa khandyanmadhye sthanik aswasthata yete jyamule khande aakunchan pavtat. dolhyatil aswasthata door karnyasathi khaaj sutane kinwa dolhe mitavane yasarkhe vastavik tick yaa tanav kinwa sanvedanapasun aaram denare vatoo shakate. torrett asalelya kahee lokanna kadachit sankochashi sambandhit purvaniyojit ichchhechi jaaniv nasel. praudhanpeksha mulanna yabaddal qamee mahitee asoo shakate, parantu tyanchi jagrukta paripakvatesah vadhate; vayachya dahavya varshaparyant, bahutek mule purvaniyojit ichcha olakhatat.
tikchya aadhichya purvamonitary aagrahamule aasann tikche dadapshahi shakya hote. tyanchya aadhichya aagrahamule, aakunchananna visheshtah 'anaichhik' aivaji ardh-aichchhik kinwa 'anaichhik' mhanoon varnan kele jaate; teey avanchhit purvasuchanachya aagrahala 'aichchhik', dadapun taknyayogya pratisad mhanoon anubhavale jaau shakatat. aakadi dadapanyachi kshamata vyaktinnusar badalate aanee mulanpeksha praudhanmadhye adhik vikasit houu shakate. tick asalele lock kadhikadhi tyanna maryadit kalavadhisathi dadapun takoo shakatat, parantu asey kelyane anekada tanav kinwa mansik thakwa yeto. torrett asalele lock dadapalelya ichchhesathi nirjan jaaga shodhu shakatat kinwa shalet kinwa kamachya thikani dadapshahichya kalavadhinantar aakadi lakshaniy vaadh houu shakate. doctoranchya karyalayat asatana mule aswasthata dadapun takoo shakatat, tyamule jevha tyanchyavar laksh thewale jaat asalyachi jaaniv nasate tevha tyanchyavar laksh thevane aavashyak asoo shakate.
bolanyashi sambandhit guntaguntichya trasanmadhye koprolaliya, ikolalia aanee palilalia yancha samavesh hoto. koprolaliya mhanje samajikdrushtya aaksheparh kinwa nishiddha shabd kinwa vakyanshanche utsfurt uchcharan. jaree heey torretche sarvat prasiddha lakshan asale taree, torrett asalele keval 10 takke lock teey pradarshit karatat aanee nidanasathi teey aavashyak nasate. ikolalia (itaranchya shabdanchi punaravrutti) aanee palilalia (swatachya shabdanchi punaravrutti) heey alpasankhyak prakarananmadhye ghadatat. jatil motor tixmadhye coproprexia (ashleel kinwa nishiddha havbhav kinwa ayogya sparsh), ecopraxia ecopraxia vyaktichya krutinchi punaravrutti kinwa anukaran) aanee palypraxia (swatachya halchalinchi punaravrutti) yancha samavesh hoto.
prarambh aanee pragati.
torrett syndromeche konatehi vaishishtyapurn prakaran nahee, parantu suruvatiche vay aanee lakshananchi tivrata tivrata vishvasarh marg anusarate. jaree suruvat athara varshanpurvi kadhihi houu shakate, taree aakadichi suruvat honyache samanya vay paach teey saat asate aanee samanyatah paugandavasthepurvi asate. yell baal abhyas kendrane 1998 madhye kelelya abhyasat asey disun aale qee aath teey baaraa vayogatatil tyachya sarvoch tappyavar pohocheparyant tikchi tivrata vayanusar vadhali. bahutek mulanmadhye paugandavasthetun jaat asatana tyanchi tivrata satatyane qamee hote, jevha ardhi teey done trutiyansh mulanmadhye aakadichi tivrata lakshaniyaritya qamee hote.
tii. ess. asalelya lokanmadhye, disanari pahili aakadi sahasa doke, chehara aanee khandyavar parinam karate aanee tyat dolhe mitane, mitane halchali, soonghane aanee ghasa saaf karane yancha samavesh hoto. swaratil aakunchan anekada motor aakunchananantar mahine kinwa varshanni disun yete parantu pratham disu shakate. jyaa lokanna adhik tivra sankochacha anubhav yeto, tyanchyat "haat saral karane, sparsh karane, sparsh karane, udee marane, udee marane aanee firane" yasah guntaguntichya sankocha vikasit houu shakatat. parasparvirodhi vikaranmadhye (udaharanarth, swa-uttejana aanee rudhiprayog yasarkhya swa-swaleenata varnapat vikaranmadhye) vegvegalya halchali asatat.
torrett asalelya lokanmadhye lakshananchi tivrata mothya pramanat badalate aanee anek prakarane naan shodhali geleli asoo shakatat. bahutek prakarane saumya aanee jawaljawal laksh naan deta yenari asatat; tii. ess. asalelya anek lokanna kadachit tyanna tras hott asalyachi jaaniv honar nahee. kaaran aakadi adhik samanyatah khajgi swarupat vyakt kelee jaatat, tyamule torrett syndrome olakhala jaau shakat nahee aanee aakasmik nirikshakanchya lakshat kadachit aakadi yenar naheet. tii. ess. chya bahutek abhyasanmadhye purushancha samavesh asato, jyanche tii. ess. chey praman mahilanpeksha jaast asate aanee ling-aadharit farkancha changla abhyas keela jaat nahee; 2021 chya punaravalokanat asey suchavale gele aahe qee mahilanchi vaishishtye aanee pragati, visheshtah praudhavasthet, bhinn asoo shakate aanee adhik changlya abhyasachi aavashyakta aahe.
tii. ess. asalelya bahutek praudhanmadhye saumya lakshane asatat aanee teey vaidyakeey madat ghet naheet. kishoravasthenantar bahutansh lokanmadhye aakadi qamee hott asatana, praudhanmadhye 'aakadi vikaranche kahee sarvat gambhir aanee durbal karnare prakar' aadhaltat. kahee prakarananmadhye, praudh-suruvatichya aakadi mhanje balpanatil aakadi punha samore yeu shakatat.
shakatat paristhiti.
saumya lakshane asalelya lokanna vishesh chikitsalayanmadhye pathvanyachi shakyata naslyamule, torretchya abhyasat adhik gambhir prakarananvishayi antarnihit purvagrah asato. jevha lakshane chikitsalayanna pathvanyachi hummy denyasathi pureshi gambhir asatat, tevha aii. dii. etch. dii. aanee oo. see. dii. dekhil anekada aadhaltat. vishesh chikitsalayanmadhye, tii. ess. asalelya 30 takke lokanmadhye manahsthiti kinwa chinta vikar kinwa vighatankari vartane dekhil asatat. aii. dii. etch. dii. chya anupasthitit, tick vikar heey vighatankari vartan kinwa karyatmak durbalateshi sambandhit asalyache disat nahee, tarr jyanna adhik sahvyadhi aahet tyanchyat shaala, kutumb kinwa samvayask sambandhanmadhil durbalata jaast asate. jevha aii. dii. etch. dii. heey aakadisah upasthit asate, tevha aachar vikar aanee virodhi avadnyatmak vikar vadhatat. tii. ess. asalelya lokanmadhil aakramak vartane aanee santapt udrek heey changlya prakare samajale jaat naheet; teey gambhir sankochashi sambandhit naheet, parantu aii. dii. etch. dii. chya upasthitishi sambandhit aahet. aii. dii. etch. dii. chintechya uchch daranmadhye dekhil yogdan deu shakate aanee jevha oo. see. dii. aanee aii. dii. etch. dii. donhi torretchya saha-udbhavtat tevha aakramakta aanee raag niyantran samasya adhik sambhavtat.
oo. see. dii. asalelya kahee vyaktinmadhye sankochanansarkhi sakti asate; 'tick-sambandhit oo. see. dii.' haah oo. see. dii. chaa upasamuh asalyache gruheet dharale jaate, joou oo. see. dii. peksha gair-tick sambandhit oo. see. dii. pasoon waid aanee saktichya prakar aanee swarupanusar vegala aahe. dushitateshi sambandhit tikshivay oo. see. dii. chya adhik vaishishtyapurn saktichya tulanet, tick-sambandhit oo. see. dii. adhik "mojani, aakramak vichar, samamiti aanee sparsh" saktisah sadar karate. oo. see. dii. shhee sambandhit sankochananshivaychya sakti samanyatah waid aanee chinteshi sambandhit asatat, tarr tick-sambandhit oo. see. dii. madhye asalelya saktila purvasuchanachi ichcha asate. jyanna oo. see. dii. dekhil aahe asha tii. ess. asalelya praudhanmadhye chinta aanee nairashyache praman vadhate.
chikitsalayanmadhye abhyas kelelya tii. ess. asalelya vyaktinmadhye, 2.9 teey 20 takke darmyan swaleenata spectrum vikar hote, parantu eka abhyasatoon asey soochit hote qee swaleenata aanee tii. ess. chaa uchch sambandh anshatah sankochan aanee sankochan-sarkhya vartananmadhil farak karnyat karnyat adchaninmule kinwa autism asalelya lokanmadhye disanari oo. see. dii. lakshane yamule asoo shakato.
torrett asalelya serve lokanna aii. dii. etch. dii. kinwa oo. see. dii. kinwa itar sahvyadhijanya paristhiti nasatat aanee shuddha tii. ess. kinwa tii. ess.-fakt 15 teey 57 takke darancha andaj asato; vaidyakeey loksankhyemadhye, kalji anand lokanpaiki uchch takkevarit aii. dii. etch. dii. asate. shuddha tii. ess. asaleli mule aanee paugandavasthetil mule aakramak vartanook kinwa aachar vikaranchya manankanavar kinwa samajik anukulan upayanvar tii. ess.shivay tyanchya samvayaskanpeksha lakshaniyaritya bhinn nasatat. tyachpramane, shuddha tii. ess. asalelya praudhanna tii. ess. plus aii. dii. etch. dii. asalelyanmadhye samajik adachani upasthit asalyache disat nahee.
vruddhatvachya suruvatichya vayamadhye, madak padarthancha adhik durupyog aanee manahsthitiche vikar aadhaltat aanee swatahun dukhapatgrast houu shakatat. jyaa praudhanna gambhir, anekada upchar-pratirodhak sankochan asate tyanna dekhil manahsthitiche vikar aanee oo. see. dii. honyachi shakyata jaast asate. gambhir aakadi aanee anek sahvyadhi asalelya lokanmadhye koprolaliya honyachi shakyata jaast asate.
neurocycological karya.
torrett asalelya lokanmadhye neurocycological karyat konatihi mothee kamatarata nasate, parantu sankochanansah sankochanansah paristhitimule neurocognitive karyat farak houu shakato. keval tii. ess.-vyakti aanee sahvyadhi asalelya lokanmadhil konatehi neurocycological farak ughad karnyasathi sahvyadhi asalelya paristhitinchi adhik changli samaj aavashyak aahe.
bauddhik kshamata, laksh denyachi kshamata aanee ashabdik smaranshaktimadhye keval kirkol dosh aadhaltat-parantu aii. dii. etch. dii., itar sahvyadhi vikar kinwa tick tivrata yaa farkansathi karanibhoot asoo shakatat. purvichya nishkarshanchya ulat, drushya motor ektrikaran aanee vijoconstructive kaushalye bighadaleli aadhalat naheet, tarr sahvyadhi asalelya paristhiticha motor kaushalyanvar thodasa parinam houu shakato. comorbid sthitee aanee aakadichi tivrata heey maukhik askhalitatemadhye badalanare parinam asoo shakatat, jeey thodese bighadu shakatat. samajik aakalanshaktimadhye thodishi kamatarata asoo shakate, parantu niyojan karnyachya kinwa nirnay ghenyachya kshamatet nahee. fakt tii. ess. asaleli mule sandnyanatmak kamatarata darshavat naheet. motor samanvay velevar kelelya chachanyanvar teey tyanchya vayanusar sarasaripeksha vegwan asatat aanee satat tick dadapanamule vadhiv pratibandhatmak niyantranamule karyanmadhye badal karnyat fayda houu shakato.
shikanyatil apangatva asoo shakate, parantu teey sankochan kinwa sahvyadhi paristhitimule aahet qee nahee heey vadgrast aahe; shikanyatil apangatvache uchch darr nondavalelya junya abhyasanni sahvyadhi sthitichya upasthitisathi changle niyantran thewale nahee. hastalikhitat anekada adachani yetat aanee tii. ess. aanee itar atty asalelyanmadhye lekhee abhivyakti aanee ganitatil apangatva nondavale jaate.
karane.
torretche nemke kaaran adnyat aahe, parantu heey changlya prakare siddha jhaale aahe qee tyat anuvanshik aanee paryavaraniy donhi ghatak samavisht aahet. anuvanshik mahamarishastra abhyasatoon asey disun aale aahe qee torrett heey atyant varshane milanare aahe aanee samanya loksankhyepeksha jawalchya kutumbatil sadasyanmadhye aadhalanyachi shakyata 10 teey 100 putt jaast aahe. varshachi achook paddhat dnyat nahee; ekahi januk olakhali gelee nahee aanee tyat shekado januke samavisht asanyachi shakyata aahe. 2013 aanee 2015 madhye genome-wide association abhyas prakashit karnyat aale hote jyamadhye konatahi shodh mahattvapurnatechya umbarathyavar pohochala nahee; 2019 chya meta-vishleshanat gunasutra 13 varr keval ekach genome-wide mahattvapoorn sthan aadhalale, parantu too parinam vyapak namunyanmadhye aadhalala nahee. julya abhyasatoon asey disun aale aahe qee 50 teey 77 takke eksaman julya mulanche tii. ess. nidan hote, tarr keval 10 teey 23 takke bhratru julya mulanche nidan hote. parantu aanuvanshik asurakshitata varshane varshane pratyekamadhye lakshane disun yenar naheet. kahee durmil atyant bhedak anuvanshik utparivartan aadhalale aahet jeey ekach kutumbatil kutumbatil, etch. dii. see." aanee "see. aine. tii. aine. aii. aii januke) keval thodya pramanat prakarananche spashtikaran detat.
manosamajik kinwa itar gair-aanuvanshik ghatak-jaree teey uratesche kaaran nasale taree-asurakshit vyaktinmadhye tii. ess. chya tivratevar parinam karoo shakatat aanee varshane midalelya janukanchya abhivyaktivar prabhav takoo shakatat. prasutipoorv aanee prasutipoorv ghatananmule anuvanshik asurakshitata asalelyanmadhye tick vikar kinwa comorbid oo. see. dii. vyakt honyacha dhoka vadhato. yamadhye pityache vay; sandushache prasooti; garodarpanat tanav kinwa tivra malmal; aanee garbhadharanedarmyan tambakhu, caffeen, alcohole aanee ganjacha vapar yancha samavesh hoto. qamee vajanachya janmachya velee kinwa qamee aii. pii. jee. aar. gunank asalelya balanna dekhil dhoka vadhato; qamee vajanachya janmachya julya mulanmadhye tii. ess. honyachi shakyata jaast asate.
svayampratikar prakriya aakunchanachya suruvativar parinam karoo shakatat kinwa tyanna tivra karoo shakatat. oo. see. dii. aanee tick vikar heey donhi, streptococcal nantarchya svayampratikar prakriyechya parinami mulanchya upasanchat udbhavtat asey gruheet dharale jaate. tyachya sambhavya parinamache varnan pandas (streptococcal sansargashi sambandhit balrogat autoimmune neurocychiatric vikar) navachya vadgrast gruhitkadvare kele jaate, jeey mulanmadhye nidanasathi paach nikash prastavit karate. panda aanee naveen balrogat tivra-prarambh neurocychiatric syndrome (panne) gruhitak heey vaidyakeey aanee prayogshaletil sanshodhanache kendrabindu aahet, parantu teey apramanit aahet. rogpratikarak pranalitil vikrutee aanee rogpratikarak vikar yancha sambandh tii. ess. shhee jodanare eka vyapak gruhitak dekhil aahe.
oo. see. dii. chey kahee prakar anuvanshikdrushtya torretshee jodalele asoo shakatat, jaree oo. see. dii. madheel aanuvanshik ghatak ticks aanee nasatanahi bhinn asoo shakatat. tathapi, aii. dii. etch. dii. chaa uret syndromeshy asalela anuvanshik sambandh purnapane sthapit jhalela nahee. autism aanee torrett yanchyatil anuvanshik sambandh 2017 paryant sthapit jhalela nahee.
yantrana.
torretchya varshane midalelya asurakshitatevar parinam karnari achook yantrana changlya prakare sthapit keleli nahee. thalamus, besal ganglia aanee frontal cortex yaa cortical aanee subcourtical menduchya bhaganmadhil nishkriyatemule aakadi udbhavtat asey manale jaate. neuroenatomic models menduche aachchadan aanee subcourtex subcourtex paripathanmadhye apayash soochit karatat; imaging tantre frontal cortex aanee besal ganglia soochit karatat. 2010 chya dashakat, neuroimaging aanee shavavichedan mendu abhyas, tasech prani aanee anuvanshik abhyasanni, neurobiological yantrana adhik changlya prakare samajoon ghenyachya dishene pragati kelee jyamule torrets hoto. heey abhyas besal ganglia modella samarthan detat, jyamadhye pattyatil neurons sakriy hotat aanee besal gangliamadhun output rokhatat.
courtico-strieto-thalemo-courtical (see. ess. tii. see.) circuits kinwa neural pathve, cortexmadhun besal gangliala input pradan karatat. halchali, vartan, nirnay ghene aanee shikanyache niyojan aanee niyantran niyantrit karnari mahitee hastantarit karnyasathi hii paripath besal ganglia menduchya itar bhaganshi jodatat. yaa paripathanmadhun 'mahitiche ektrikaran karnyas parvanagi parvanagi paraspar jodanidware vartan niyantrit kele jaate. censorimotor, limbic, bhasha aanee nirnay ghenyachya margansah yaa see. ess. tii. see. paripathanmadhil doshanmule anaichhik halchali houu shakatat. yaa paripathanmadhil vikrutee yaa aakunchan aanee purvaniyojit aagrahasathi jababdar asoo shakatat.
torretchya see. ess. tii. see. paripathatil pathologychya gruhitkala samarthan dett, coddet kendrak heey tick nasalelya vishayachya tulanet tick asalelya vishayanmadhye lahan asoo shakatat. sankochan dadapanyachi kshamata menduchya paripathanvar avalambun asate jee "pratisad pratibandh aanee motor vartanache sandnyanatmak niyantran niyantrit karate". tii. ess. asalelya mulanmadhye eka motha prefrontal cortex aadhalato, joou ticks niyantrit karnyat madat karnyasathichya rupantaramule houu shakato. pudhil aachchhadanachi kshamata jasjashi vadhate tastashi vayanusar aakadi qamee honyachi shakyata asate. courtico-besal ganglia (see. bii. jee.) circuit dekhil bighadu shakatat, jyamule "sanvedi, avayavi aanee karyakari" vaishishtyanmadhye yogdan milate. torrett asalelya lokanmadhye besal gangliamadhye dopamineche strav jaast asate, jyamule "atee sakriy aanee aniyamit dopaminergic sankraman" pasoon jaivarasayanik badal hotat.
majjatantu paripathatil badalanmadhye histamine aanee shakatat receptor bhoomika bajavu shakatat. shakatat receptormadhye histaminechi patali qamee jhalyamule itar neurotransmittermadhye vaadh houu shakate, jyamule sankochan houu shakate. shavavichedan abhyasanmadhye 'neuroenflamatory prakriyanche aniyamitikaran' dekhil samavisht aahe.
nidan.
mansik vikaranchya nidanatmak aanee sankhyikeey niyamavalinusar" (dii. ess. emm.-5), jevha ekhadi vyakti eka varshachya kalavadhit anek motor tick aanee eka kinwa adhik vocal tick donhi darshavate tevha torretche nidan kele jaau shakate. motor aanee vocal tick ekach velee asanyachi garaj nahee. hii suruvat vayachya 18 vya varshapurvi jhaali asavi aanee itar sthitee kinwa padarthachya (jase qee koken) parinamanna jababdar dharata yenar nahee. tyamule, itar vaidyakeey paristhiti jyat aakadi kinwa aakadisarkhya halchalincha samavesh aahe-udaharanarth, swaleenata kinwa aakadichi itar karane-nakarli pahijet.
tick vikarasathi sandarbhit kelelya rugnanche moolyankan tyanchya kautumbik itihasachya tick, aii. dii. etch. dii. chee asurakshitata, obsessive-compulsive lakshane aanee itar anek junat vaidyakeey, mansik aanee majjasansthesambandhichya paristhitichya aadhare kele jaate. vishisht suruvat aanee aakadi kinwa oo. see. dii. chaa kautumbik itihas asalelya vyaktinmadhye, moolbhut sharirik aanee majjasansthechi tapasani pureshi asoo shakate. torretche nidan karnyasathi konatyahi vishisht vaidyakeey kinwa tapasani chachanya naheet; nidan sahasa vyaktichi lakshane aanee kautumbik itihasachya nirikshanavar aanee tick vikaranchi duyyam karane (torretism) nakarlyanantar kele jaate.
vilambit nidan anekada ghadate kaaran vyavsayikanna chukun asey vatate qee tii. ess. durmil aahe, nehmi koprolaliyacha samavesh asato kinwa gambhirpane bighadalele asale pahije. dii. ess. emm. neey 2000 pasoon olakhale aahe qee torrett asalelya anek vyaktinmadhye lakshaniy ashaktapana nasato; nidanasathi koprolaliya kinwa aii. dii. etch. dii. kinwa oo. see. dii. sarkhya comorbid sthitichi aavashyakta nasate. saumya (bahutansh prakarananmadhye) kinwa madhyam teey gambhir (durmil parantu adhik vyapakpane olakhali jaanari aanee prasiddha jhaleli prakarane) asha tivratechya vyapak abhivyaktimule torretche chukiche nidan kele jaau shakate. torrett syndrome asalelya sumare 20 takke lokanna tyanna ticks aahet heey lakshat yet nahee.
tii. ess. chya suruvatichya kalat prayatnansah aakadicha anekada allergy, damaa, drushti samasya aanee itar paristhitinshi gondhal hoto. balrogatadnya, aelarjitadnya aanee netratadnya heey mulala sankochan asalyache pahanare kinwa olakhanare pratham aahet, jaree bahutek sankochan heey mulachya palakanni pratham olakhale aahe. khokala, dolhe mitane aanee damyasarkhya asambandhit paristhitichi nakkal vapar aakadiche samanyatah chukiche nidan kele jaate. yuu. keey. madhye, lakshane disane aanee nidan darmyan sarasari teen varshancha vilamb hoto. 
vibhedak nidan.
torretchya nakkal karnare disanare-parantu torrett vyatirikt itar vikaranshi sambandhit asalele-torretism mhanoon olakhale jaatat aanee torrett syndromechya vibhedak nidanat nakarle jaatat. koriyaj, dystonia, myoclonus aanee diskinesiashi sambandhit asamanya halchali torretchya sankochananpeksha vegalya aahet kaaran tyaa adhik laybaddh asatat, dadapanyajogya nasatat aanee tyapurvi avanchhit ichcha nasate. vikasatmak aanee swaleenata spectrum vikaranmule aakunchan, itar rudhivadi halchali aanee rudhivadi halchalincha vikar prakat houu shakato. swalinateshi sambandhit rudhivadi halchalinche vay samanyatah suruvatiche asate; adhik samamiteey, laybaddh aanee dwaipakshik asatat; aanee tyat hatpayancha samavesh asato (udaharanarth, haat fadfadne).
jarr dusari sthitee tanatanav adhik changlya prakare spasht karoo shakat asel, tarr chachanya kelya jaau shakatat; udaharanarth, tanatanav aanee japti kriyakalap yanchyat nidanatmak gondhal asalyas, eka eae. eae. jee. aurder keela jaau shakato. emm. aar. aay. menduchya vikrutee nakaru shakate, parantu asha menduchya pratimechya abhyasachi sahasa hummy nasate. thyroid-uttejak samprerak rakt patali mojane hypothyroidism nakaru shakate, jeey aakadiche kaaran asoo shakate. jarr yakrutachya rogacha kautumbik itihas asel tarr seeram copper aanee ceryuloplasminchi patali willson rogala nakaru shakate. tii. ess. chya suruvatiche samanya vay paugandavasthepurviche asate. achanak aakadi padane aanee itar vartanukichi lakshane asalelya kishoravayin aanee praudhanmadhye, uttejak dravyansathi mootra aushadh padadyasathi vinanti kelee jaau shakate.
covid-19 mahamarichya kalat anek deshanmadhye kishoravayin mulinmadhye (pramukhyane kishoravayin mulee) khokalyasarkhya vartanache vadhate prasang nondavale gele. sanshodhakanni tyanchya ghatanecha sambandh kahee tiktok kinwa youtube kalakaranchya anuyayanshi jodala. 2006 madhye 'cycogenic' mhanoon varnan kelelya, aakasmit halchalinsarkhya achanak-prarambh kalat halchalinna 'karyatmak halchal vikar' kinwa 'karyatmak tick-sarkhya halchali' mhanoon sambodhale jaate. karyatmak tick-sarkhya halchalinna sendriya (mansik) kaaran asalelya tikpasoon vegale karane katheen asoo shakate. teey ektech udbhavu shakatat kinwa ticks vikar asalelya vyaktinmadhye saha-astitvat asoo shakatat. hii sankochan anek prakare tii. ess. chya abhijat sankochananshi visangat aaheth purvaniyojit ichcha (sankochan vikar asalelyanpaiki 90 takke lokanmadhye upasthit) karyatmak sankochan-sarkhya halchalinmadhye anupasthit asate; sankochan vikaranmadhye disanari dadpan qamee asate; sankochanancha kautumbik kinwa balpanatil itihas nahee aanee karyatmak sankochananmadhye mahilanche varchasva aahe, pahilya sadarikaranachya nantarchya vayasah; suruvat adhik soochit kalat halchalinchya samanyatepeksha adhik achanak hote; aanee qamee saha-udbhavnare oo. see. dii. kinwa aii. dii. etch. dii. aanee adhik saha-udbhavnare vikar aahet. karyatmak sankochan heey "purnapane rudhivadi nasatat", aushadhanna pratisad dett naheet, mutravardhak sankochananche abhijat vaccing aanee ksheen hott jaanare swaroop darshavat naheet aanee vishisht paddhatine pragati karat naheet, jyamadhye sankochan sahasa sahasa pratham disun yete aanee haloohaloo avayavankade jaate.
itar jyaa paristhitimadhye aakadi prakat houu shakatat tyamadhye sydenhamcha koria; idiopathic dystonia; aanee huntingtoncha rog, neuroachanthocytosis, pantothenate keynage-sambandhit neurodegeneration, dukene snayu dystrophy, willsoncha rog aanee tuberus sclerosis yasarkhya anuvanshik paristhiti samavisht aahet. itar shakyatanmadhye daun syndrome, clinefelter syndrome, exvii syndrome aanee najuk ex syndrome yasarkhe gunasutra vikar samavisht aahet. aushadh-prerit aakadi, dokyala aaghat, mendujwara, stroke aanee carbon monoxide vishbadha hii aakadichya adhigrahit karananmadhye samavisht aahet. lesh-nihan syndromechya atyant swayam-dukhapatgrast vartanancha torrett syndrome kinwa rudhivadi vartananshi gondhal houu shakato, parantu hinsak sankochanechya prakarananmadhye dekhil swayam-dukhapat durmil aahe. yapaiki bahutek sthitee hii vran vikaranpeksha durmil aahet aanee vaidyakeey kinwa tapasani chachanyanshivay tyancha sampoorn itihas aanee tapasani tyanna nakarnyasathi pureshi asoo shakate.
itar paristhitinsathi tapasani.
torrett asalelya sarvanna sahvyadhichi sthitee nasali taree, vaidyakeey dekhbhalisathi upasthit asalele bahutek lock tyanchya sankochanasah itar paristhitinchi lakshane darshavtat. aii. dii. etch. dii. aanee oo. see. dii. heey sarvat samanya aahet, parantu autism spectrum vikar kinwa chinta, manahsthiti, vyaktimatva, virodhi avadnyatmak aanee aacharan vikar dekhil asoo shakatat. shikanyatil apangatva aanee zopeche vikar asoo shakatat; zopetil adthala aanee ardhashishiche praman samanya loksankhyepeksha jaast asalyache nondavale jaate. jevha lakshane aanee ashaktapana aavashyak asato tevha sahvyadhiche sakhol moolyankan kele jaate aanee tii. ess. asalelya lokanchya kaljipurvak mulyamapanamadhye yaa paristhitinsathi sarvasamaveshak tapasani samavisht asate.
oo. see. dii. aanee aii. dii. etch. dii. sarkhya sahvyadhigrast sthitee heey aakadipeksha adhik bighadu shakatat aanee ekoon karyavar adhik parinam karoo shakatat. sahvyadhiyukt torrett aanee aii. dii. etch. dii. asalelya vyaktinmadhye vighatankari vartane, bighadaleli karyapaddhati kinwa sandnyanatmak durbalata yancha aii. dii. etch. dii. dware hishob keela jaau shakato, jyamule sahvyadhiyukt paristhiti olakhanyache mahatva adhorekhit hote. jyaa mulanna shikanyat adachani aahet ashee tii. ess. asaleli mule aanee paugandavasthetil mule hii manoshikshan chachanisathi umedvar aahet, visheshtah jarr mulalahi aii. dii. etch. dii. asel.
vyavasthapan.
torretwar konatahi upchar nahee. konatehi sarvat prabhavi aushadh nahee aanee konatehi eka aushadh serve lakshananvar prabhavipane upchar karat nahee. tixsathi lihoon dileli bahutek aushadhe tyaa vaparasathi manjur keleli naheet aanee konatehi aushadh lakshaniy pratikool parinamanchya jokhmishivay nahee. upchar heey sarvat trasdayak kinwa bighadaleli lakshane olakhane aanee tyaa vyaktila tyanche vyavasthapan karnyat madat karnyavar kendrit aahe. kaaran sahvyadhiyukt sthitee hii anekada aakadipeksha vikruticha motha srot asalyane, tyanna upcharanmadhye pradhanya dile jaate. torretche vyavasthapan vaiyaktik aahe aanee tyat chikitsak, rugna, kutumb aanee kalji ghenare yanchyat samayik nirnay ghene samavisht aahe. american academy auph neurologyne 2019 madhye tixchya upcharasathi sarav margdarshak tattve prakashit kelee hotee.
bahutansh prakarananmadhye shikshan, aashvasan aanee manovikarachya upcharpaddhati upcharpaddhati puresha asatat. visheshtah, rugna aanee tyanche kutumb aanee aaspaschya samudayala lakshya karnare manoshikshan heey eka pramukh vyavasthapan dhoran aahe. jeey karyatmakdrushtya ashakt naheet tyanchyasathi savadhgirine pratiksha karane haah eka sweekarya marg aahe. lakshananchya vyavasthapanamadhye vartanukishi nigadit, mansik aanee aushadhashastriy upcharancha samavesh asoo shakato. aushadhashastriy hastakshep adhik gambhir lakshanansathi rakheev aahe, tarr mansopchar kinwa sandnyanatmak vartanukichi upcharpaddhati (see. bii. tii.) nairashya aanee samajik algikaran sudharu shakate aanee kutumbacha pathimba sudharu shakate. vartanukishi sambandhit kinwa aushadhashastriy upcharancha vapar karnyacha nirnay "sahasa kahee mahinyanchya kalavadhisathi shaikshanik aanee sahayyak hastakshepanantar ghetala jaato aanee heey spasht aahe qee khokalyachi lakshane satat gambhir asatat aanee aatmasanman, kutumb kinwa samvayaskanshi asalele sambandh kinwa shaletil kamgirichya babatit teey swatah eka durbalateche srot asatat".
manoshikshan aanee samajik samarthan.
tick vikaransathichya vyavasthapan yojnanmadhye dnyan, shikshan aanee samajootdarpana heey sarvoch aahet aanee manoshikshan hii pahili payari aahe. samanyatah mulachya palakanna tyanchya aakadi disane pahilyanda lakshat yete; tyanna kalji vatoo shakate, teey kasetari jababdar aahet ashee kalpana karoo shakatat kinwa torretbaddalchya chukichya mahitimule tyanna bhaar vatoo shakato. palakanna nidanabaddal prabhavipane shikshit karane aanee samajik pathbal dene hii tyanchi chinta qamee karoo shakate. yaa aadharamule tyanchya mulala anavashyak aushadh dile jaanyachi kinwa tyanchya palakanchya bhavnik sthitimule tras vadhanyachi shakyata dekhil qamee houu shakate.
jarr tyanchya aakadikade "vichitra" mhanoon pahile tarr torrett asalelya lokanna samajik tras houu shakato. jarr ekhadya mulala samajik kinwa shaikshanik karyat adthala aananari angvichedan kinwa angvichedan asel, tarr sahayyak mansopchar kinwa shaletil nivas upayukt tharoo shakatat. saumya chikatpana asaleli mulehi vadhaleli chidavani, gundgiri, samvayaskankadun nakar kinwa samajik kalank yamule ragavu shakatat, nairashyat asoo shakatat kinwa tyancha aatmasanman qamee houu shakato aanee yamule samajik maghar houu shakate. kahee mule tyanchya vargamitranna samvayask jagrukta karyakram sadar karoon sashakt vatatat. shikshak aanee shaletil shaletil vishisht aakadi, divasa tyanchyat chadh-utaar kase hotat, mulavar tyancha kassa parinam hoto aanee aakadi aanee dusht vartan yaat farak kassa karayacha yabaddal shikshit karane upayukt tharoo shakate. tick olakhayala shikoon, praudh mulane tick thambavanyachi vinanti karane kinwa apeksha karane talhu shakatat, kaaran "tick dadapane thakavanara, apriy aanee laksh vedhoon ghenyasarkhe asoo shakate aanee parinami nantar punha tikchi sthitee udbhavu shakate".
tii. ess. asalele praudh tyanchya aakunchananmule kalank aanee bhedbhav talhanyasathi samajikaritya maghar gheu shakatat. tyanchya deshachya aarogya seva vyavasthenusar, tyanna samajik seva kinwa sahayyak gatankadoon madat miloo shakate.
vartanook.
savay ulat prashikshan (etch. aar. tii.) aanee sampark aanee pratisad pratibandh (eae. aar. pii.) vaparoon vartanukivaril upchar heey torrett syndromechya vyavasthapanatil pahilya-olinche hastakshep aahet aanee teey prabhavi asalyache disun aale aahe. kaaran sankochan kahise dadapanyajoge asate, jevha tii. ess. asalelya lokanna sankochan honyapurvichya purvasuchanachi jaaniv asate, tevha tyanna sankochan honyachya ichchela pratisad vikasit karnyasathi prashikshit kele jaau shakate. tixsathi (see. bii. tii.) sarvasamaveshak vartanukicha hastakshep haah etch. aar. tii. varr aadharit aahe, joou tixsathi sarvottam sanshodhan kelela vartanukicha upchar aahe. etch. aar. tii./see. bii. tii. saha (sankochanankade durlaksh karnyaivaji) sankochanambaddal mulachi jagrukta vadhavalyane nantarchya aayushyat adhik sankochan houu shakate qaa yavar tii. ess. tadnya vaad ghalatat.
jevha sahvyadhi asalelya paristhitishi sambandhit vighatankari vartane astitvat asatat, tevha raag niyantran prashikshan aanee palak vyavasthapan prashikshan prabhavi tharoo shakate. oo. see. dii. asatana see. bii. tii. haah eka upayukt upchar aahe. vyayam, yog aanee dhyan yasarkhi vishrantichi tantre, taana qamee karnyasathi upayukt tharoo shakatat jyamule taana vadhu shakato. etch. aar. tii. chya palikade, torretsathichya bahutansh vartanukichya hastakshepanche (udaharanarth, vishranti prashikshan aanee jaiv-poshan) paddhatshirpane moolyankan kele gele nahee aanee tyanna anubhavjanya samarthan dile jaat nahee.
aushadhopachar.
jevha tyanchi aakadi sarvat gambhir asate tevha aakadi asaleli mule samanyatah upasthit asatat, parantu sthitee vadhate aanee qamee hote mhanoon, aushadhe lagech suru kelee jaat naheet kinwa varanvar badalali jaat naheet. shikshan, aashvasan aanee anukool vatavaranamule aswasthata qamee houu shakate. jevha aushadh vaparale jaate, tevha lakshane door karane heey uddisht nasate. tyaeivaji, pratikool parinamanshivay lakshane vyavasthapit karnari sarvat qamee matra vaparali jaate, kaaran aushadhopachar karoon upchar kelya kelya lakshananpeksha pratikool parinam adhik trasdayak asoo shakatat.
vishisht aanee asamanya neuroleptics yaa rogachya upcharanmadhye siddha jhalelya parinamkaraktechya aushadhanchya varganche dirghakalin aanee alpakalin pratikool parinam houu shakatat. kahee uchcharaktadabavirodhi ghatakancha vapar aakadivar upchar karnyasathi dekhil keela jaato; abhyas badalanari parinamkarakta darshavtat parantu neurolepticspecsha qamee dushparinam profile darshavtat. uchcharaktadabavirodhi clonidine aanee gwanfacin samanyatah mulanmadhye pratham vaparale jaatat; teey aii. dii. etch. dii. chya lakshananmadhye dekhil madat karoo shakatat, parantu teey praudhansathi prabhavi aahet yache qamee purave aahet. jevha uchcharaktadabavirodhi aushadhe prabhavi nasatat tevha neuroleptics resperidone aanee eripiprazolecha vapar keela jaato aanee samanyatah praudhansathi pratham keela jaato. qamee dushparinamanmule, itar manovikarachya aushadhanpeksha eripiprazolala pradhanya dile jaate. haloperidol heey aakadisathiche sarvat prabhavi aushadh aahe, parantu tyache dushparinam honyacha dhoka jaast asato. methylphenidate vapar aii. dii. etch. dii. varr upchar karnyasathi keela jaau shakato joou tixes saha-hoto aanee clonidines sanyojan mhanoon vaparla jaau shakato. chinta aanee oo. see. dii. vyavasthapit karnyasathi nivadak serotonin reptech inhibitorscha vapar keela jaato.
itar.
aaharatil badal, neurofeedback aanee allergy chachani aanee niyantran yasarkhya purak aanee paryayi aushadh paddhatinche lokpriy aakarshan aahe, parantu torrett syndromechya vyavasthapanamadhye tyancha konatahi siddha fayda nahee. puravyancha abhav asoonahi, done trutiyansh palak, kalji ghenare aanee tii. ess. asalelya vyakti aahar paddhati aanee paryayi upchar vapartat aanee nehmi tyanchya doctoranna kalvat naheet.
tetrahydrocanbinalum sankochan qamee hote assa qamee aatmavishvas aahe aanee torretchya upcharanmadhye ganja-aadharit itar aushadhansathi apura purava aahe. acupuncture kinwa transcranial chumbakeey uttejananchya vaparas samarthan denare konatehi changle purave naheet; tasech pandanchya upcharasathi antahshira immunoglobulin, plazma exchange kinwa pratijaivikanna samarthan denare purave naheet.
jaree haah eka prayogik upchar asala taree, paramparik upcharpaddhati aanee vyavasthapanala pratisad naan naan gambhir lakshane asalelya vyaktinsathi khol menduchi uttejana (dii. bii. ess.) haah eka vaidh paryay banala aahe. dii. bii. ess. chaa fayda houu houu umedvaranchi nivad karane aavhanatmak aahe aanee shastrakriyesathi yogya qamee vayachi shreni aspasht aahe; 3 takkyanpeksha qamee vyaktinmadhye heey sambhavyapane upayukt aahe. 2019 paryant lakshya karnyasathi menduche aadarsh sthan olakhale gele nahee.
garbhadharana.
eka chaturthansh striya masik palichya aadhi tyanchya aakunchan vadhalyache sangatat; tathapi, abhyasanmadhye garbhadharaneshi kinwa samprerkanchya patalishi sambandhit aakunchananchya varanvartet kinwa tivratet badal jhalyache satatyapurn purave disun aalele naheet. ekandarit, mahilanmadhil lakshane purushanpeksha haloperidola adhik changla pratisad detat.
bahutek mahilanna asey vatate qee teey garodarpanat jaast tras naan hota aushadhanpasun door rahoo shakatat. garaj bhasalyas, shakya titkya qamee matret aushadhe vaparali jaatat. garbhadharanedarmyan, garbhadharanetil guntaguntichya jokhamimule jevha shakya asel tevha neuroleptic aushadhe talhali jaatat. garaj bhasalyas, olanzapine, resperidone aanee quetiapine bahutek vela vaparale jaatat kaaran teey garbhachya vikruteenna karanibhoot asalyache disun aalele nahee. eka ahavalat asey aadhalun aale aahe qee haloperidolcha vapar garbhadharanedarmyan keela jaau shakato, jyamule qamee raktadab aanee anticholinergic prabhavansah ivaril dushparinam qamee karata yetat, jaree teey naal olandu shakate.
jarr gambhir aakadi sthanik bhool denyat adthala aanoo shakatat, tarr itar bhool denyachya paryayancha vichar keela jaato. qamee matret neurolepticscha stanpan vapar balavar parinam houu shakat nahee, parantu bahutek aushadhe talhali jaatat. aaichya dudhat clonidine aanee amphetamines asoo shakatat.
purvasoochana.
torrett syndrome haah eka spectrum vikar aahe-tyachi tivrata saumya teey gambhir asate. mule paugandavasthetun jaat asatana lakshane samanyatah qamee hotat. sarvadhik tivratechya sarasari vayachya (sumare daha kinwa akra) daha mulanchya gatamadhye, jawaljawal chaar mulanna praudhatvaparyant sampoorn kshama disel. itar chaar jananmadhye praudhavasthet kamitakami kinwa saumya sankochan asel, parantu purn kshama honar nahee. urvarit doghanmadhye praudh mhanoon madhyam kinwa gambhir aakadi asateel, parantu praudhatvat tyanchi lakshane balpanapeksha kvachitach adhik gambhir asateel.
lakshananchi tivrata kahihi asali taree, torrett asalelya vyaktinche ayushya samanya asate. kahee lokanmadhye lakshane ayushyabhar aanee dirghakalin asoo shakatat, parantu hii sthitee apghatansheel kinwa jivgheni nahee. shuddha tii. ess. asalelyanmadhye buddhimatta samanya vakratenusar asate, jaree sahvyadhi asalelya lokanmadhye buddhimattemadhye thode farak asoo shakatat. aayushyachya suruvatichya kalat kalat aakadichi tivrata nantarchya aayushyat tyanchya tivratecha andaj lavat nahee. ekhadya vishisht vyaktisathi lakshanancha andaj lavnyache konatehi vishvasarh sadhan nahee, parantu nidan samanyatah anukool asate. vayachya chauda teey solavya varshaparyant, jevha samanyatah sarvadhik tick tivrata nighun jaate, tevha adhik vishvasarh purvasoochana kelee jaau shakate.
jevha tyanche nidan kele jaate tevha aakadi tyanchya sarvoch tivratevar asoo shakatat aanee ekhadya vyaktiche kutumb aanee mitranna hii sthitee adhik changlya prakare samajoon yete mhanoon anekada sudharate. abhyas ahwal detat qee torrett asalelya daha paiki jawaljawal aath mulanna praudhatvaparyant tyanchya aakadichi tivrata qamee hote aanee ajunahi aakadi asalelya kahee praudhanna kadachit teey aahet heey mahit nasel. praudhanmadhye aakadi nondavanyasathi vhidiocha vapar vapar abhyasat asey aadhalun aale aahe qee daha paiki nauu praudhanna ajunahi aakadi hote aanee swatahla aakadimukt aakadimukt ardhyahun adhik praudhanni saumya aakadiche purave pradarshit kele.
jivanacha darja.
torrett asalelya lokanvar aakadiche parinam aanee tyanna dadapanyachya prayatnancha parinam hoto. doke aanee dolhyanchya aakadyanmule vachanat vyatyay yeu shakato kinwa dokedukhi houu shakate aanee jorjorat aakadyanmule varanvar taana yeu shakate. tivra aakadimule vedna kinwa dukhapat houu shakate; udaharanarth, manechya aakaditun eka durmil grivechya diskche herniation jhalyache nondavale gele. kahee lock samajikdrushtya ayogya aakunchananna lapvayala kinwa tyanchya aakunchananchya urjecha vapar karyatmak prayatnat karayala shiku shakatat.
eka sahayyak kutumb aanee vatavaran samanyatah torrett asalelya lokanna vikar vyavasthapit karanyachi kaushalye dete. praudhavasthetil parinam heey aakunchananchya vastavik tivratepeksha lahanpanapasun aakunchan honyachya lakshat aalelya mahattvanshi adhik sambandhit asatat. jyaa vyakticha gairsamaj jhaala, shiksha jhaali kinwa gharee kinwa shalet teela chidavanyat aale, tee vyakti samajoon ghenyachya vatavaranacha anand anand mulapeksha white vagnyachi shakyata asate. gundgiri aanee chidavaniche dirghakalin parinam aatmasanman, aatmavishvas aanee agadi rojgarachya nivadi aanee sandhinvarhi prabhav takoo shakatat. comorbid aii. dii. etch. dii. serve kshetrantil mulachya kalyanavar gambhir parinam karoo shakate aanee praudhatvaparyant vistaru shakate.
tick vikarancha naisargik chadh-utaar, samna karnyachya dhoranancha vikas aanee vyaktiche vay lakshat gheta, jivanachya gunavattevar parinam karnare ghatak kalantarane badaltat. aii. dii. etch. dii. chee lakshane paripakvatesah sudharat asalyane, praudh tyanchya vyavsayik jeevanat tyanchya shaikshanik jivanatil mulanpeksha qamee nakaratmak parinam nondavtat. mulanpeksha aarthik ozesah praudhanchya manosamajik karyavar, tixcha jaast parinam hoto. nairashya kinwa chintemule jivanacha darja qamee jhalyachi nond praudhanmadhye honyachi shakyata jaast asate; mulanchya tulanet praudhanchya jivanachya gunavattevar taana yenyapeksha nairashya adhik oze nirman karate. vayanusar samna karanyachi dhorane adhik prabhavi hott asalyane, oo. see. dii. lakshanancha prabhav qamee hott asalyache disate.
mahamarishastra.
torrett syndrome hii eka samanya parantu nidan naan keleli sthitee aahe jee serve samajik, vanshik aanee vanshik gatanparyant pohochate. mahilanpeksha purushanmadhye heey teen teey chaar putt jaast aadhalate. praudhanpeksha mulanmadhye aadhalalele pradurbhavache praman jaast aahe kaaran praudhatvanantar aakadi qamee hotat kinwa qamee hotat aanee anek praudhansathi nidan aavashyak nasate. ekoon loksankhyechya 1 takkyanparyant lokanna balpanat junat aakadi aanee kshanik (tatpurte kinwa anirdisht) aakadi yasah aakadi vikarancha anubhav yeto. dirghakalin aakadi 5 takke mulanvar parinam karatat aanee kshanik aakadi 20 takkyanparyant prabhavit karatat.
ticks asalelya anek vyaktinna tyanna ticks aahet heey mahit nasate kinwa nidan shodhat naheet, mhanoon tschya sathichya rogshastriy abhyasanmadhye abhyasanmadhye paristhiti asalelyambaddal 'drudh nishchitata purvagrah pratibimbit hoto'. tii. ess. chaa nondavalela pradurbhav "namunyacha srot, vay aanee linganusar; nirdharan prakriya aanee nidan pranalinusar", mule aanee paugandavasthetil mulansathi 0.15% aanee 3. sukhodolski, ityadi. 2017 madhye lihile qee mulanmadhye tii. ess. chya prasaracha sarvottam andaj 1.4% hota. robertson aanee stern yaa doghanchehi mhanane aahe qee mulanmadhye yache praman 1 takke aahe. samanya loksankhyemadhye tii. ess. chaa prasar 0.3% teey 1.0% assa andaj aahe. shatkatil jangananechya aakadevarinusar, yaa pradurbhavachya andajanusar yuu. ess. madhye tii. ess. saha ardha dashalaksh mule aanee yuu. keey. madhye tii. ess. saha ardha dashalaksh lock jhaale, jaree anek vruddha vyaktinmadhye lakshane jawaljawal olakhata naan yenari asateel.
torrett syndrome haah ekekali durmil manla jaat aseh 1972 madhye, yuu. ess. national institute auph health (aine. aay. etch.) neey asey manale qee united statesmadhye 100 peksha qamee prakarane aahet aanee 1973 chya nondanimadhye jagbharat keval 485 prakarane nondavali gelee. tathapi, 2000 pasoon prakashit jhalelya asankhya abhyasanni satatyane dakhavun dile aahe qee yacha prasar khoop jaast aahe. heey lakshat gheuun qee tixche anekada nidan kele jaau shakat nahee aanee shodhane katheen aahe, naveen abhyasanmadhye thet varg nirikshan aanee anek mahitee denare (palak, shikshak aanee prashikshit nirikshak) vaparale jaatat aanee tyamule junya abhyasapeksha adhik prakarane nondavali jaatat. nidanatmak maryada aanee moolyankan paddhat saumya prakarananchya olakhichya dishene vatchal karat asalyane, andajit pradurbhav vadhala aahe.
tii. ess. chya uchch purush pradurbhavamule, mahilanvar maryadit mahitee aahe jyatoon ling-aadharit farkambaddal nishkarsh kadhala jaau shakato; bahutek purushanchya abhyasavar aadharit sankochachi vaishishtye aanee upcharanvishayi mahilanparyant nishkarsh pohochavtana savadhgiri balgali jaau shakate. 2021 chya punaravalokanat asey mhatale gele aahe qee striyanna lakshane purushanpeksha nantarche shikhar disu shakate, kalantarane qamee mafisah, chinta aanee manahsthiti vikaranche praman jaast asoo shakate.
itihas.
jeane marqa gaspard itard yaa french doctorne 1825 madhye torrett syndromechya pahilya prakaranachi nond kelee, jyat markis dii dampier yaa tichya kalatil eka mahattvachi kuleen mahila asalyache varnan kele. 1884 madhye, jeane-martin charkot yaa prabhavshali french vaidyane, tyacha vidyarthi aanee prashikshanarthi georges gills day laa tourett yala, unmad aanee koriyapeksha vegali sthitee paribhashit karnyachya uddeshane, salpetrier rugnalayat halchal vikar asalelya rugnancha abhyas karnyasathi niyukt kele. 1885 madhye, gills day laa touretne 'aakadi khokala vikar' asalelya nauu lokanchya 'majjatantuchya dukkhachya abhyas' madhye eka ahwal prakashit keela, jyamadhye assa nishkarsh kadhala gela qee naveen vaidyakeey shreni paribhashit kelee pahije. charkotne gillus day laa torretchya nantar aanee tyachya vatine heey naav dile hote, joou nantar charkotcha jyeshth rahivasi jhaala.
jhaala shatkatil varnanannantar, eka manovikarjanya drushtikon prachalit hota aanee aanee shatkaparyant aakadiche spashtikaran kinwa upchar karnyat farshi pragati jhaali navhati. 1918 teey 1926 yaa kalat mendujvarachya sustichya sathicha sambandh tick vikaranchya vadhishi jodala gela tevha torrett syndromes halchal vikaranche mool sendriya asanyachi shakyata nirman jhaali.
1960 aanee 1970 chya dashakat, jasha khokalyavar haloperidolche fayadeshir parinam dnyat jhaale, tasha torrett syndromechya manovishleshak drushtikonavar prashnachinh upasthit kele gele. 1965 madhye, jevha arther keey. haah nirnayak valanavar aala. shapiro-jyache varnan 'aadhunik tick disorder recerche janak' asey kele jaate-tyane torrett asalelya vyaktivar upchar karnyasathi haloperidolcha vapar keela aanee manovishleshak drushtikonavar teeka karnara eka pepper prakashit keela. 1975 madhye, 'daad newyork times' neey eka lekhache shirshak dile, jyat 'mendutil rasayanik vikaranshi sambandhit torretchya rogachya piditanchya vichitra udrekan' chey shirshak hote aanee shapiro mhanaleh 'yaa aajarachi vichitra lakshane keval tyavar upchar karnyasathi vaparlya jaanarya vichitra upcharanmulech pratispardhi aahet."
1990 chya dashakat, uretcha adhik tatasth drushtikon udayas aala, jyamadhye anuvanshik pravrutti hii anuvanshik nasalelya aanee paryavaraniy ghatkanshi parasparsanvad sadhatana disate. 1994 madhye dii. ess. emm. (dii. ess. emm.-aay. vhee.) chya chauthya punaravruttimadhye "samajik, vyavsayik kinwa kamkajachya itar mahattvachya kshetranmadhye lakshaniy tras kinwa lakshaniy bighad" sathee nidanatmak aavashyakta jodali gelee, jyamule tii. ess. tadnya aanee sanshodhakanni santap vyakt keela, jyanni nondavale qee anek lokanna tyanna tii. ess. aahe heey dekhil mahit navhate, kinwa tyanchya sankochanemule teey vyathit navhate; chikitsak aanee sanshodhakanni sanshodhan aanee saravat junya nikashancha vapar karnyacha avalamb keela. 2000 saalee, american cychiatric association durbalatechi aavashyakta door karnyasathi dii. ess. emm. (dii. ess. emm.-aay. vhee.-tii. aar.) chya chauthya majkoor punaravalokanat tyachya nidanatmak nikashat sudharana kelee, heey lakshat gheuun qee doctor anekada asha lokanna pahatat jyanna torrett aahe, tras kinwa ashaktapana nahee.
samaj aanee sanskruti.
torrett asalelya pratyekala upchar kinwa upchar havah nasato, visheshtah jarr yacha arth assa qee teey yaa prakriyet kahitari vegale gamavoo shakatat. sanshodhak lakeman aanee cohain yancha assa vishvas aahe qee torret syndrome vikasit honyashi sambandhit vyaktichya anuvanshik asurakshitateshi sambandhit supt fayade asoo shakatat, jyanche anukool moolya asoo shakate, jase qee vadhiv jagrukta aanee tapasheel aanee sabhovatalache laksh vadhavane.
kushal sangitkar, kheladu, sarvajanik vakte aanee serve kshetratil vyavsayik heey touret asalelya lokanmadhye aadhaltat. shikago tribune' neey 'durmilatam prani-american socker nayak' mhanoon aanee 'torrett syndrome association' neey 'jagbharatil torrett syndrome asaleli sarvat ullekhaneey vyakti' mhanoon varnan kelelya 'ethlete team howard' chey mhanane aahe qee tyachya majjasansthesambandhichya rachananni tyala eka vardhit dharana aanee tivra laksh kendrit kele jyamule maidanavar tyachya yashat yogdan midale.
samuel johnson hii eka aitihasik vyakti aahe jyala bahudha torrett syndrome hota, yacha purava tyacha mitra james bosvelchya likhanatoon midato. johnson yanni 1747 madhye 'ingraji bhashecha shabdakosh' lihila aanee teey eka vipul lekhak, kavee aanee samikshak hote. mosartla torrett hota yaa andajala farsa pathimba naheeh swarbaddha aakunchanancha sambhavya sahprabhavi pailu lekhanat hastantarit keela jaat nahee, mhanoon mosartche scatological lekhan sambandhit nahee; sangitkarancha upalabdh vaidyakeey itihas sakhol nahee; itar paristhitinchya dushparinamancha chukicha arth lavala jaau shakato; aanee "mosartchya jivanatil motor aakunchanancha purava sanshayaspad aahe".
gills day laa touretchya kamapurvichya kalpanik kathanmadhil tii. ess. kinwa tick vikaranche sambhavya chitran shree. charles decainschya 'little dorit' madheel panks aanee lio tolstoychya 'annah carrenina' madheel 'nikolai levin'. torrett syndrome asalelyanna samajik apaprakar mhanoon chitrit kelyabaddal manoranjan udhyogavar teeka kelee gelee aahe, jyanche ekmev toke mhanje koprolaliya aahe, jyamule janatecha torret asalelya lokambaddalcha gairsamaj aanee kalank vadhala aahe. uretchi sahprabhavi lakshane hii americetil redio aanee durchitravanivaril charcha karyakramansathi aanee british madhyamansathi dekhil chaara aahet. uchch-profile madhyam coverage, menduchya sakhol uttejanasarkhya surakshitata kinwa parinamkarakta sthapit naan kelelya upcharanvar laksh kendrit karate aanee abhyas naan kelelya parinamkarakta aanee dushparinamancha samavesh asalelya paryayi upcharancha anek palak pathpurava karatat.
sanshodhan disha.
1999 pasoonchya sanshodhanala janukshastra, neuroimaging, neurophysiology aanee neuropathology yaa kshetranmadhye torretche pragat dnyan aahe, parantu tyache sarvottam vargikaran kase karave aanee itar halchalinshi kinwa mansik vikaranshi tyacha kitee jawalcha sambandh aahe yabaddal prashna shillak aahet. itar majjatantu vikasatmak vikaranmadhye mothya pramanat kelelya prayatnansah prayatnansah anuvanshik pragatinantarche model, teen gut torretchya anuvanshashastrachya sanshodhanat sahkarya karat aaheth
autism, schizophrenia aanee bipolar disorder yaa vishisht neurodevelopmental kinwa mansik aarogya vikaranmadhye januk shodhat jhalelya pragatichya tulanet, united statesmadhye sambandhit tii. ess. sanshodhanache praman nidhimule mage padat aahe.

