Two Cases of Tourette’s Syndrome by M.M. Van Benschoten, OMD

Two Cases of Tourette’s Syndrome by M.M. Van Benschoten, OMD

Tourette’s syndrome is a neurological disorder characterized by motor and/or vocal tics.  The condition is 4 times more prevalent in boys than girls.  Recent research indicates immune dysfunction as a major component of this multifactorial disease.  Hyperactivation of T and B cells with impaired antibody responses create persistent infections, and decreased numbers of regulatory T cells indicate an autoimmune component. 

In our clinical experience, low grade bacterial, viral, and fungal infections induce immune system cross reactivity and inflammation targeting the blood brain barrier, neurohormones, and their receptor sites in susceptible children. Streptococcal and viral infections may induce inflammation of the brain, especially the basal ganglia. Herbal prescriptions should be changed at each visit to avoid resistance due to mutation of microbial pathogens and autoantibodies to herbal medicines.

TCM diagnosis of Tourette’s syndrome is related to syndromes of internal Wind, Liver heat and fire with blood deficiency.  Heat and toxins damage yin, causing blood deficiency, and stirring of internal Wind.  Phlegm fire from retained pathogens is another contributing factor.  Treatment principles include clearing heat and toxins, extinguishing internal Wind, and calming shen.

Case 1.

Master A is 7 years old, with a history of pneumonia at age 3 weeks, air travel at age 3 months, eczema age 4.  Breast fed for 6 months, cow’s milk formula, allergies to dust, pet hair, previous use of topical and inhaled steroids, antibiotics. Sleeps on a memory foam pillow, carpet in bedroom, mattress is 10 years old.  Symptoms include night sweats, poor appetite, severe continuous facial and body tics during entire examination.

11/20/11

alpinia fruit, houttuynia, imperata, corydalis, ginseng red, zizyphus spinosa, centella, lindera, moutan, thlaspi, asparagus, schizandra

Alpinia fruit (yi zhi ren), houttuynia (yu xing cao), corydalis (yan hu suo), ginseng red (hong shen), zizyphus spinosa (suan zao ren), centella (ji xue cao), moutan (mou dan pi), asparagus (tian men dong), and schizandra (wu wei zi) have anticonvulsant effects.  Houttuynia and moutan are antiinfluenza and antistreptococcus. Asparagus reduces TNF and inhibits strep.  Imperata (bai mao gen) reduces capillary permeability and moutan (mou dan pi) strengthens the blood brain barrier.  Lindera (wu yao) reduces the excitotoxic effects of glutamate.  Thlaspi (bai jiang cao) inhibits strep and has a sedative effect.  Corydalis (yan hu suo) relaxes striated muscles.

3/19/12

ganoderma, ocimum, trigonella, bupleurum, codonopsis, acorus, cuscuta, polygonatum root

Ganoderma (ling zhi) has antiinfluenza and antiherpes virus effects.  Bupleurum (chai hu) inhibits influenza and seizure activity.  Codonopsis (dan shen) and polygonatum root (huang jing) benefit T cell functions.  Ocimum (jiu ceng ta) has anticonvulsant effects and improves appetite.  Acorus (shi chang pu) and cuscuta (tu su zi) have sedative and antiseizure effects and protect mitochondrial function.  Trigonella (hu lu ba) improves appetite and reduces insulin resistance.

5/10/12

gambir, gentiana macrophylla, angelica sinensis, paeony, anemarrhena, scute

Gambir (gou teng) is neuroprotective and anticonvulsant.  Gentiana macrophylla (qin jiao) interacts with the benzodiazepine receptor and has sedative action.  Angelica sinensis (dang gui) and paeony (bai shao) have antiherpesvirus and antistreptococcal effects, assist the clearance of circulating immune complexes, and inhibit complement.  Anemarrhea (zhi mu) and scute (huang qin) are anticonvulsant, antistreptococcal, and antiinfluenza.

10/8/12

Repeat of the 11/20/11 formula based on the patient’s positive response

3/26/13

No observable motor tics or facial movements, calm and seated during entire examination

Case 2.

Master B is 8 years old with motor tics for the past two years.  Eye blinking, sniffling, shoulder and jam movements began after vaccinations and ear infections.  Previous asthma diagnosis and use of inhaled steroids with multiple courses of antibiotics.  No surgical history.

10/26/10

bupleurum, gambir, acorus, paeony, siler, centella, asparagus, angelica sinensis, scute, schizandra

Bupleurum (chai hu), gambir (gou teng), siler (fang feng), and centella (ji xue cao) are anticonvulsant and antiinfluenza.  Scute (huang qin) and schizandra (wu wei zi) bind to the GABA receptor and have sedative and antistreptococcal effects.

5/5/11

Strep throat, Amoxicillin, increased tics neck and whole body

gastrodia, polygala, prunella, corydalis, hibiscus, zizyphus spinosa, magnolia bark, thlaspi

Gastrodia (tian ma), polygala (yuan zhi), corydalis (yan hu suo) are anticonvulsant.  Prunella (xia gu cao) and thlaspi are antistreptococcal.  Magnolia bark has a muscle relaxant effect.

1/19/13

Better control of neck, 2 weeks sore throat

cnidium, gambir, tribulus, houttuynia, asparagus, scute, corydalis, paeony, anemarrhena, moutan

Cnidium (chuan xiong) and gambir (gou teng) have sedative and anticonvulsant effects.  Houttuynia (yu xing cao), asparagus (tian men dong), scute (huang qin), anemarrhena (zhi mu), and moutan (mou dan pi) are antistrep and anticonvulsant.

3/26/13

Tics reduced patient’s mother requests discontinuation of treatment

Chinese herbal medicines with antibacterial, antiviral, and anticonvulsant effects are useful in the management of Tourette’s syndrome.  Internal wind corresponds to the autoimmune inflammation of the central nervous system from common infections and environmental toxins.  Persistent treatment over several years is essential to manage this complex disorder.

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