Tourette's Syndrome Glossary of Medical Terms

Abdominal: Relating to the abdomen, the belly , that part of the body that contains all of the structures between the chest and the pelvis . The abdomen is separated anatomically from the chest by the diaphragm , the powerful muscle spanning the body cavity below the lungs .
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Abnormal: Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer ).
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ADHD: Attention deficit hyperactivity disorder .
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Anxiety: A feeling of apprehension and fear characterized by physical symptoms such as palpitations , sweating, and feelings of stress . Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated.
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Arms: An appendage in anatomy and in clinical trials . See: Arm .
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Attention deficit hyperactivity disorder : A family of related chronic neurobiological disorders that interfere with an individual's capacity to:

• regulate activity level (hyperactivity),
• inhibit behavior (impulsivity), and
• attend to tasks (inattention) in developmentally appropriate ways. The term "attention deficit hyperactivity disorder" is abbreviated and usually referred to as ADHD.

The core symptoms of ADHD include an inability to sustain attention and concentration, developmentally inappropriate levels of activity, distractibility, and impulsivity.
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Autoimmune: Pertaining to autoimmunity, a misdirected immune response that occurs when the immune system goes awry and attacks the body itself.
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Autosomal: Pertaining to a chromosome that is not a sex chromosome; relating to any one of the chromosomes save the sex chromosomes.
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Autosomal dominant: A pattern of inheritance in which an affected individual has one copy of a mutant gene and one normal gene on a pair of autosomal chromosomes. (In contrast, autosomal recessive diseases require that the individual have two copies of the mutant gene.) Individuals with autosomal dominant diseases have a 50-50 chance of passing the mutant gene and therefore the disorder onto each of their children. Examples of autosomal dominant diseases include Huntington disease , neurofibromatosis , and polycystic kidney disease .
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Basal ganglia: A region consisting of 3 clusters of neurons (called the caudate nucleus , putamen , and the globus pallidus ) located at the base of the brain that are responsible for involuntary movements such as tremors, athetosis , and chorea . The basal ganglia are abnormal in a number of important neurologic conditions including Parkinson disease and Huntington disease . The term "basal ganglia" refers to the fact that this region is in the "basement" of the brain.
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Behavior therapy: A treatment program that involves substituting desirable behavior responses for undesirable ones.
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Benzodiazepines: A class of drugs that act as tranquilizers and are commonly used in the treatment of anxiety. Benzodiazepines can cause drowsiness.
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Bipolar disorder : A mood disorder sometimes called manic-depressive illness or manic-depression that characteristically involves cycles of depression and elation or mania . Sometimes the mood switches from high to low and back again are dramatic and rapid, but more often they are gradual and slow, and intervals of normal mood may occur between the high ( manic ) and low (depressive) phases of the condition. The symptoms of both the depressive and manic cycles may be severe and often lead to impaired functioning.
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Botulinum toxin: A toxin produced by the bacterium Clostridium botulinum that is the most poisonous biological substance known. Botulinum toxin acts as a neurotoxin . It binds to the nerve ending at the point where the nerve joins a muscle, blocking the release by the nerve of the chemical acetylcholine (the principal neurotransmitter at the neuromuscular junction), preventing the muscle from contracting. The result is weakness and paralysis of the muscle. The muscle atrophies. The blockage of acetylcholine release is irreversible. Function can be recovered by the sprouting of nerve terminals and the formation of new synaptic contacts, which usually takes 2 to 3 months.
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Brain: That part of the central nervous system that is located within the cranium ( skull ). The brain functions as the primary receiver, organizer and distributor of information for the body. It has two (right and left) halves called "hemispheres."
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Breathing: The process of respiration, during which air is inhaled into the lungs through the mouth or nose due to muscle contraction, and then exhaled due to muscle relaxation.
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Cardiovascular: The circulatory system comprising the heart and blood vessels which carries nutrients and oxygen to the tissues of the body and removes carbon dioxide and other wastes from them.
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Chorea: Ceaseless rapid complex body movements that look well coordinated and purposeful but are, in fact, involuntary.
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Chronic: This important term in medicine comes from the Greek chronos, time and means lasting a long time.
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Clinical trials: Trials to evaluate the effectiveness and safety of medications or medical devices by monitoring their effects on large groups of people.
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Cluster: In epidemiology, an aggregation of cases of a disease or another health-related condition, such as a cancer or birth defect, closely grouped in time and place. The number of cases in the cluster may or may not exceed the expected number. This is determined by cluster analysis, a set of statistical methods used to analyze clusters.
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Co-morbid: Pertaining to two or more disorders simultaneously.
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Complication: In medicine, an additional problem that arises following a procedure, treatment or illness and is secondary to it. A complication complicates the situation.
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Contraindication: A condition which makes a particular treatment or procedure inadvisable. A contraindication may be absolute or relative.

• An absolute contraindication is a situation which makes a particular treatment or procedure absolutely inadvisable. In a baby, for example, aspirin is absolutely contraindicated because of the danger that aspirin will cause Reye syndrome .

• A relative contraindication is a condition which makes a particular treatment or procedure somewhat inadvisable but does not rule it out. For example, X-rays in pregnancy are relatively contraindicated (because of concern for the developing fetus ) unless the X-rays are absolutely necessary.

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Depression : An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
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Diagnosis: 1 The nature of a disease ; the identification of an illness. 2 A conclusion or decision reached by diagnosis. The diagnosis is rabies . 3 The identification of any problem. The diagnosis was a plugged IV.
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Dopamine: An important neurotransmitter (messenger) in the brain.
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DSM-IV: The 4th edition of "Diagnostic and Statistical Manual of Mental Disorders" ( DSM ) a comprehensive classification of officially recognized psychiatric disorders. DSM-IV was issued in 1993.
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Dyskinesia: Difficulty or distortion in performing voluntary movements, as in tic, chorea, spasm, or myoclonus. The term dyskinesia may be used in relation to Parkinson's disease and other extrapyramidal disorders. Dyskinesia can occur as a side effect of certain medications such as L-dopa and the antipsychotics.
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Essential: 1. Something that cannot be done without.
2. Required in the diet, because the body cannot make it. As in an essential amino acid or an essential fatty acid.
3. Idiopathic. As in essential hypertension. "Essential" is a hallowed term meaning "We don't know the cause."
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Evolution: The continuing process of change, especially in reference to natural selection.
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Exacerbate: To make worse. For example, smoking may exacerbate systemic lupus erythematosus .
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Familial: A condition that is tends to occur more often in family members than expected by chance alone. A familial disease may be genetic (such as cystic fibrosis ) or environmental (such as tuberculosis ).
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Fatigue: A condition characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness and tiredness. Fatigue can be acute and come on suddenly or chronic and persist.
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Gene: The basic biological unit of heredity . A segment of deoxyribonucleic acid (DNA) needed to contribute to a function.
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Genetic: Having to do with genes and genetic information.
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Guided imagery: An alternative medicine technique in which patients use their imagination to visualize improved health, or to "attack" a disease, such as a tumor. Some studies indicate that the positive thinking can have an effect on disease outcome, so this technique is now utilized as "complimentary medicine" in some oncology centers and other medical facilities.
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Herbal: 1. An adjective, referring to herbs, as in an herbal tea.
2. A noun, usually reflecting the botanical or medicinal aspects of herbs; also a book which catalogs and illustrates herbs.
The word "herbal" was pronounced with a silent "h" on both sides of the Atlantic until the 19th century but this usage persists only on the American side.
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Heredity: Genetic transmission from parent to child.
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Hyperactivity: A higher than normal level of activity. An organ can be described as hyperactive if it is more active than usual. Behavior can also be hyperactive.
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Imagery: Both a mental process (as in imagining) and a wide variety of procedures used in therapy to encourage changes in attitudes, behavior, or physiological reactions. As a mental process, it is often defined as "any thought representing a sensory quality." It includes, as well as the visual, all the senses - aural, tactile, olfactory, proprioceptive, and kinesthetic.
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Immune: Protected against infection. The Latin immunis means free, exempt.
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Incidence: The frequency with which something, such as a disease, appears in a particular population or area. In disease epidemiology, the incidence is the number of newly diagnosed cases during a specific time period. The incidence is distinct from the prevalence which refers to the number of cases alive on a certain date.
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Indication: 1. In medicine, a condition which makes a particular treatment or procedure advisable. CML (chronic myeloid leukemia ) is an indication for the use of Gleevec (imatinib mesylate). 2. A sign or a circumstance which points to or shows the cause, pathology , treatment, or outcome of an attack of disease. The presence of the Philadelphia chromosome in peripheral blood cells is an indication of a relapse in CML.
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Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a "germ") growing within him, drawing its nourishment from the person.
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Inheritance: Not something that is contained in a will, but rather a gene, chromosome or genome that is transmitted from parent to child.
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Involuntary: Done other than in accordance with the conscious will of the individual. The opposite of voluntary.
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Itching: An uncomfortable sensation in the skin that feels as if something is crawling on the skin or in the skin, and makes the person want to scratch the affected area.
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Medical school: A school with a curriculum leading to a medical degree. The mission of every medical school includes medical teaching, research, and patient care. All medical schools share the goal of preparing students in the art and science of medicine, and providing them with the background necessary to enter the period of graduate medical education. The years of medical school preceding graduate medical education are typically divided into a preclinical phase and a clinical phase.
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Mortality: A fatal outcome or, in one word, death. The word "mortality" is derived from "mortal" which came from the Latin "mors" (death). The opposite of mortality is, of course, immortality. Mortality is also quite distinct from morbidity (illness).
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Mortality rate: A death rate . There are a number of different types of mortality rates as, for examples, the following:

• The fetal mortality rate : The ratio of fetal deaths to the sum of the births (the live births + the fetal deaths) in that year.
• The infant mortality rate : The number of children dying under a year of age divided by the number of live births that year.
• The maternal mortality rate : The number of maternal deaths related to childbearing divided by the number of live births (or by the number of live births + fetal deaths) in that year.

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Motor: In medicine, having to do with the movement of a part of the body. Something that produces motion or refers to motion. For example, a motor neuron is a nerve cell that conveys an impulse to a muscle causing it to contract. The term "motor" today is also applied to a nerve that signals a gland to secrete. Motor is as opposed to sensory.
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Mouth: 1. The upper opening of the digestive tract, beginning with the lips and containing the teeth, gums, and tongue. Foodstuffs are broken down mechanically in the mouth by chewing and saliva is added as a lubricant. Saliva contains amylase, an enzyme that digests starch. 2. Any opening or aperture in the body. The mouth in both senses of the word is also called the os, the Latin word for an opening, or mouth. The o in os is pronounced as in hope. The genitive form of os is oris from which comes the word oral.
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MRI: Abbreviation and nickname for magnetic resonance imaging . For more information, see: Magnetic Resonance Imaging ; Paul C. Lauterbur ; Peter Mansfield .
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Muscle: Muscle is the tissue of the body which primarily functions as a source of power. There are three types of muscle in the body. Muscle which is responsible for moving extremities and external areas of the body is called "skeletal muscle." Heart muscle is called "cardiac muscle." Muscle that is in the walls of arteries and bowel is called "smooth muscle."
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Neck: The part of the body joining the head to the shoulders. Also, any narrow or constricted part of a bone or organ that joins its parts as, for example, the neck of the femur bone.
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Neurology: The medical specialty concerned with the diagnosis and treatment of disorders of the nervous system -- the brain, the spinal cord, and the nerves.
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Obsessive-compulsive disorder: A psychiatric disorder characterized by obsessive thoughts and compulsive actions, such as cleaning, checking, counting, or hoarding. Obsessive-compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person's life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, at school, or even in the home.
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OCD: 1. Obsessive-compulsive disorder ; 2. Osteochondritis dissecans .
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Onset: In medicine, the first appearance of the signs or symptoms of an illness as, for example, the onset of rheumatoid arthritis . There is always an onset to a disease but never to the return to good health. The default setting is good health.
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PANDAS: An acronym for Pediatric Autoimmune Disorders Associated with Strep.
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Pediatric: Pertaining to children.
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Penetrance: The likelihood a given gene will result in disease. For example, if half (50%) of the people with the neurofibromatosis (NF) gene have the disease NF, the penetrance of the NF gene is 0.5.
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Perinatal: Pertaining to the period immediately before and after birth. The perinatal period is defined in diverse ways. Depending on the definition, it starts at the 20th to 28th week of gestation and ends 1 to 4 weeks after birth. The word "perinatal" is a hybrid of the Greek "peri-" meaning "around or about" and "natal" from the Latin "natus" meaning "born."
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Pregnancy : The state of carrying a developing embryo or fetus within the female body. This condition can be indicated by positive results on an over-the-counter urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about nine months, measured from the date of the woman's last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long.
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Prevalence: The proportion of individuals in a population having a disease. Prevalence is a statistical concept referring to the number of cases of a disease that are present in a particular population at a given time.
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Prognosis: 1. The expected course of a disease .
2. The patient's chance of recovery.
The prognosis predicts the outcome of a disease and therefore the future for the patient . His prognosis is grim, for example, while hers is good.
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Psychiatric: Pertaining to or within the purview of psychiatry , the medical specialty concerned with the prevention, diagnosis , and treatment of mental illness.
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Recurrence: The return of a sign, symptom or disease after a remission. The reappearance of cancer cells at the same site or in another location is, unfortunately, a familiar form of recurrence.
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Referral: The recommendation of a medical or paramedical professional. If you get a referral to ophthalmology, for example, you are being sent to the eye doctor. In HMOs and other managed care schemes, a referral is usually necessary to see any practitioner or specialist other than your primary care physician (PCP), if you want the service to be covered. The referral is obtained from your PCP, who may require a telephone or office consultation first.
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Sedative: A drug that calms a patient down, easing agitation and permitting sleep . Sedatives generally work by modulating signals within the central nervous system. These sedatives can dangerously depress important signals needed to maintain heart and lung function if they are misused or accidentally combined, as in the case of combining prescription sedatives with alcohol. Most sedatives also have addictive potential. For these reasons, sedatives should be used under supervision, and only as needed.
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Sensation: In medicine and physiology , sensation refers to the registration of an incoming ( afferent ) nerve impulse in that part of the brain called the sensorium , which is capable of such perception. Therefore, the awareness of a stimulus as a result of its perception by sensory receptors. (Sensory is here synonymous with sensation.)
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Shoulder: A structure made up of two main bones: the scapula ( shoulder blade ) and the humerus (the long bone of the upper arm). The end of the scapula, called the glenoid, is a socket into which the head of the humerus fits, forming a flexible ball-and-socket joint . The scapula is an unusually shaped bone. It extends up and around the shoulder joint at the rear to create a roof called the acromion and around the shoulder joint at the front to constitute the coracoid process. The shoulder joint is cushioned by cartilage that covers the face of the glenoid socket and the head of the humerus. The joint is stabilized by a ring of fibrous cartilage around the glenoid socket that is called the labrum . Ligaments connect the bones of the shoulder and tendons join these bones to surrounding muscles. The biceps tendon attaches the biceps muscle to the shoulder and helps stabilize the joint. Four short muscles that originate on the scapula pass around the shoulder where their tendons fuse together to form the rotator cuff .
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Sleep : The body's rest cycle.
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Sleep disorders: Any disorder that affects, disrupts, or involves sleep . The most common sleep disorder is probably snoring, although it is usually not medically significant. Insomnia, sleep apnea , restless leg syndrome , and sleepwalking are also sleep disorders. Most large medical centers have diagnostic and treatment facilities dedicated to sleep disorders.
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Stereotactic: Stereotactic refers to precise positioning in three-dimensional space. For example, biopsies, surgery or radiation therapy can be done stereotactically.
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Stress: Forces from the outside world impinging on the individual. Stress is a normal part of life that can help us learn and grow. Conversely, stress can cause us significant problems.
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Surgery: The word "surgery" has multiple meanings. It is the branch of medicine concerned with diseases and conditions which require or are amenable to operative procedures. Surgery is the work done by a surgeon. By analogy, the work of an editor wielding his pen as a scalpel is s form of surgery. A surgery in England (and some other countries) is a physician's or dentist's office.
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Sydenham chorea: An acute neurologic disorder that emerges several months following a streptococcal (" strep ") infection, most frequently in children between the age of 5 and 15. There may be a history of a strep throat or a strep skin infection. There may similarly be a history of another sequel of a strep infection such as scarlet fever, glomerulonephritis or, especially, rheumatic fever .
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Symptomatic: 1 With symptoms, as a symptomatic infection . 2 Characteristic, as behavior symptomatic of Huntington disease . 3 Directed at the symptoms, as symptomatic treatment .
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Syndrome: A set of signs and symptoms that tend to occur together and which reflect the presence of a particular disease or an increased chance of developing a particular disease.
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Tardive dyskinesia: A neurological syndrome characterized by repetitive, involuntary, purposeless movements caused by the long-term use of certain drugs called neuroleptics used for psychiatric, gastrointestinal and neurological disorders such as Parkinson's disease . Features may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Impaired movements of the fingers may appear as though the patient is playing an invisible guitar or piano. The incidence of the syndrome rises with the dose and duration of drug treatment. The treatment of tardive dyskinesis is usually to stop or minimize the use of the offending drug. However, for some patients with a severe underlying condition this may not be a feasible option. Replacing the offending drug with substitute drugs may help. Other drugs such as benzodiazepines, adrenergic antagonists, and dopamine agonists may also be beneficial. In an individual case, the symptoms of tardive dyskinesia may remain long after discontinuation of the offending drug or the symptoms may improve or disappear with time.
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Therapy: The treatment of disease .
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Throat: The throat is the anterior (front) portion of the neck beginning at the back of the mouth , consisting anatomically of the pharynx and larynx . The throat contains the trachea and a portion of the esophagus .
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Tic: A repetitive movement that is difficult, if not impossible, to control. Tics can affect any group of muscles. The most common are facial tics, such as eye- blinking, nose-twitching, or grimacing. Tics that affect the muscles used to produce speech are known as vocal tics, and can range from grunts or whistles to the repetition of complete words or phrases. Complex motor tics involve multiple, sequenced movements, and can include behaviors such as twirling in place, tapping a certain number of times, or stooping to touch the ground. Tics are believed to arise in differences in or damage to the basal ganglia, a structure deep within the brain that controls automatic movements and that also affects impulsivity.
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Tic disorder: A disorder characterized by the presence of tics. If both motor and vocal tics are present for more than six months, the diagnosis of Tourette syndrome may be made. Diagnosis is by observation. Treatment is not usually recommended for minor tics that are not bothersome to the patient. When treatment is desired, medication choices include the blood-pressure drugs guanfacine (brand name: Tenex) and catapres (brand name: Clonadine), or one of the atypical or older neuroleptics.
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Tiredness: See: Tired .
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Torticollis: The most common of the focal dystonias, torticollis is a state of excessive of inadequate muscle tone in the muscles in the neck that control the position of the head. It can cause the head to twist and turn to one side, and the head may also be pulled forward or backward.
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Tourette syndrome : A tic disorder characterized by the presence of chronic vocal and motor tics, probably based on differences in or damage to the basal ganglia of the brain.
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Toxin: One of a number of poisons produced by certain plants, animals, and bacteria.
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Transcranial: Through the cranium . As, for example, in transcranial magnetic stimulation .
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Transcranial magnetic stimulation: Abbreviated TMS. A non-invasive technique that consists of a magnetic field emanating from a wire coil held outside the head. The magnetic field induces an electrical current in nearby regions of the brain. TMS was originally developed as a diagnostic tool for mapping brain function. It appears promising as a treatment for some neuropsychiatric conditions, particularly major depression.
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Trigger: Something that either sets off a disease in people who are genetically predisposed to developing the disease, or that causes a certain symptom to occur in a person who has a disease. For example, sunlight can trigger rashes in people with lupus .
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Voluntary: Done in accordance with the conscious will of the individual. The opposite of involuntary.
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Weight loss: Weight loss is a decrease in body weight resulting from either voluntary ( diet , exercise ) or involuntary (illness) circumstances. Most instances of weight loss arise due to the loss of body fat, but in cases of extreme or severe weight loss, protein and other substances in the body can also be depleted. Examples of involuntary weight loss include the weight loss associated with cancer , malabsorption (such as from chronic diarrheal illnesses ), and chronic inflammation (such as with rheumatoid arthritis ).
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