Gilles de la Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by tics that frequently hide complex spectra with behavioral disorders. Medical intervention should rely on multimodal strategies including nutritional assessment and dietetic support as patients can suffer from impulsive eating and the medications often cause metabolic side effects. We present for the first time the case and treatment of a boy suffering from a severe phenotype of TS who experienced hyperphagia, weight gain, gastrointestinal disturbances, and nutritional delusions. Brief annotations about both differential nutritional assessment and underlying drug-related implications are also offered. The parents were educated on healthy eating, drug-food interactions, and hunger delay techniques. After the symptom-driven personalization of drug therapy, the start of cognitive behavioral therapy, and the escalation of the dietetic plan, the boy managed to lose weight and maintain healthy eating habits at the three-year follow-up. We reaffirm the importance of not only including a nutritionist in the management team of patients with TS, but also of assuring that the nutritional protocol perfectly integrates a comprehensive strategy in order to obtain long-term results.

Successful nutrition-based approach in Gilles de la Tourette syndrome heralding drug side effects : A case report and short review / M. Briguglio, D. Bernardo, M. Porta. - In: NUTRITION CLINIQUE ET METABOLISME. - ISSN 0985-0562. - (2021 Jul 08). [Epub ahead of print] [10.1016/j.nupar.2021.01.111]

Successful nutrition-based approach in Gilles de la Tourette syndrome heralding drug side effects : A case report and short review

M. Briguglio
;
D. Bernardo;
2021

Abstract

Gilles de la Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by tics that frequently hide complex spectra with behavioral disorders. Medical intervention should rely on multimodal strategies including nutritional assessment and dietetic support as patients can suffer from impulsive eating and the medications often cause metabolic side effects. We present for the first time the case and treatment of a boy suffering from a severe phenotype of TS who experienced hyperphagia, weight gain, gastrointestinal disturbances, and nutritional delusions. Brief annotations about both differential nutritional assessment and underlying drug-related implications are also offered. The parents were educated on healthy eating, drug-food interactions, and hunger delay techniques. After the symptom-driven personalization of drug therapy, the start of cognitive behavioral therapy, and the escalation of the dietetic plan, the boy managed to lose weight and maintain healthy eating habits at the three-year follow-up. We reaffirm the importance of not only including a nutritionist in the management team of patients with TS, but also of assuring that the nutritional protocol perfectly integrates a comprehensive strategy in order to obtain long-term results.
Le syndrome de Gilles de la Tourette (TS) est un trouble neurodéveloppemental caractérisé par des tics qui cachent souvent des spectres complexes avec des troubles du comportement. L’intervention médicale doit reposer sur des stratégies multimodales qui incluent une évaluation nutritionnelle et un soutien alimentaire, car les patients peuvent avoir une alimentation impulsive et les médicaments peuvent provoquer des effets secondaires métaboliques. Nous présentons pour la première fois le cas et le traitement d’un garçon souffrant d’un phénotype TS sévère qui manifeste une hyperphagie, une prise de poids, des troubles gastro-intestinaux et des délires nutritionnels. De brèves notes sont également fournies sur l’évaluation nutritionnelle différentielle et les implications pharmacologiques. Les parents du garçon ont été informés des principes d’une alimentation saine, des interactions médicamenteuses et des techniques de retard de la faim. Suite à la personnalisation de la pharmacothérapie, de la thérapie comportementale et cognitive, et de l’intensification du régime alimentaire, le garçon a pu perdre du poids et maintenir de saines habitudes alimentaires lors du suivi de trois ans. Nous réaffirmons l’importance d’inclure un nutritionniste dans l’équipe de prise en charge des patients TS et de veiller à ce que le protocole nutritionnel intègre parfaitement une stratégie globale pour obtenir des résultats à long terme.
Gilles de la Tourette syndrome; metabolic side effects of drugs and substances; diet; eating behavior; case management; syndrome de Gilles de la Tourette; effets secondaires métaboliques des médicaments et substances; régime méditerranéen; comportement alimentaire; pratique clinique
Settore MED/49 - Scienze Tecniche Dietetiche Applicate
Settore MED/26 - Neurologia
Settore MED/25 - Psichiatria
Settore MED/39 - Neuropsichiatria Infantile
Settore MED/42 - Igiene Generale e Applicata
8-lug-2021
8-lug-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/855938
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