Escalas en Neurología - Sociedade Galega de Neuroloxia

12-ESCALAS (225-262) 3/6/08 12:54 Página 258
I.J. POSADA, J. GONZÁLEZ DE LA ALEJA, J. BENITO-LEÓN, F. BERMEJO PAREJA, P. MARTÍNEZ-MARTÍN
Escala 81. TOURETTE'S SYNDROME GLOBAL SCALE (TSGS) (Cont.)
Symptom description and scoring codes Score
Description of motor symptoms
Simple motor tics (A)
Rapid, darting, «meaningless»: Eyeblinking, grimacing, nose twitching, lip pouting. shoulder
shrugs, arm jerks, headjerks, abdominal tensing, rapid kicks, finger movements, jaw snaps,
tooth clicking, frowning, rapid jerking of any part of body.
Complex Motor Tics (B)
Slower, «purposeful»: hopping, clapping, touching objects or others or self, throwing, arranging,
gyrating and bending, «dystonic» postures, bitting mouth, lip, arm, headbanging, thrusting
arms, striking out, picking scabs, writhing movements, rolling eyes to the ceiling, holding funny
expressions, back on a pencil while writting, tearing paper or books.
Copropraxia: «Giving the finger» —cursing through gestures.
Description of phonic symptoms
Simple phonic symptoms: fast «meaningless» sounds (C)
Whistling, coughing, sniffling, spitting, screeching, barking, grunting, gurgling, clacking, hawking,
hissing, sucking, uh-uh, eee, ah-uh, ah, and innumerable other sounds.
Complex phonic symptoms: language (D)
Words, phrases, statements: Shut up, stop that, OK. I've got to. I'm going to better-right? Right.
What makes me do this. How about it. Now you've seen it, all right, oh boy.
Rituals: Counting rituals. Repeating a phrase until it is «just right».
Speech atypicalities: Unusual rhythms, tone, accents, intensity of speech.
Coprolalia: Obscene and aggressive words and statements.
Symptom description and scoring codes
Behavior (E)
Provocative, argumentative, poor frustration tolerance, temper fíts (with three main
areas of interaction; peers. school or authority figures and family relations)
Score
No problems, normal relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
Somewhat more than normal behavior problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Subtle problems, no particular relationship threatened . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Strained relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-9
Visible problem, at least one relationship impaired. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Degree of impairment (example: if OK relationship in school and peers
10
but not with family, 14) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-14
Clear impairment in more than one area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Degree of impairment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19
Serious impairment, affect all areas, occasional interactions . . . . . . . . . . . . . . . . . . . . . . . . .
Degree and number of social interactions (Example: older broher and
20
patient nave good relationship) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unacceptable social behavior, no attempt at good social interaction.
21-24
Cannot be trusted, constant supervision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Motor restlessness (F)
Increased motor activity, more than normal movement for task
Normal movement for task, good concentration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0
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