
Tourette
Syndrome (or TS) is a neurological disorder characterized
by involuntary movements and sounds, referred to as
tics. In recent years, the number of people diagnosed
with TS has increased. The incidence of the disorder
tends to be greater in males than in females. Cases
of TS have been reported throughout the world without
differentiation based on race, culture, or socioeconomic
level.
Tics
are the most noticeable symptom of TS. A tic is a physical
or verbal behavior that people with TS do, even though
they have no control over it. People with TS have motor
and vocal tics, and these tics can be simple or complex.
Examples of simple and complex motor and vocal tics
are provided below.
|
Simple
Motor Tics
|
Complex
Motor Tics
|
|
Eye
Blinking
|
Jumping
|
|
Head
Jerking
|
Smelling
Objects
|
|
Shoulder
Shrugging
|
Touching
Objects
|
|
Simple
Vocal Tics
|
Complex
Vocal Tics
|
|
Whistling
|
Repeating
Words
|
|
Humming
|
Changes
in volume of voice
|
|
Throat
Clearing
|
Making
animal-like sounds
|
Some
people have tics but do not have TS. To be diagnosed
with TS, someone must have both motor and vocal tics;
these tics must have started before the person was 18
years of age, but tics usually start when a child is
between 5 and 8 years of age.
Tics
are involuntary; while some people can suppress them
for a while, the tics usually emerge more intensely
after this period of suppression. Imagine trying not
to blink; after a while, you would just have to do it.
An individual's tics change over time, involving different
parts of the body and different sounds. Also, tics increase
and decrease in severity at irregular intervals. This
waxing and waning of symptoms is considered a hallmark
of TS.
A
relatively rare but well-publicized type of complex
vocal tic is called coprolalia, in which the person
involuntarily utters obscene or profane words. While
this type of TS is often shown in the media, it actually
occurs in only about 15% of the TS population.
Associated
Disorders
In
some cases, TS is accompanied by other disorders. Approximately
50 to 75 percent of individuals diagnosed with TS have
problems with attention, hyperactivity, and impulse
control. Some people with TS and also attention and
hyperactivity symptoms may have temper outbursts, mood
swings, confrontational behavior, and aggression. It
is unclear whether these behaviors are part of the disorder,
associated disorders, or caused by the frustration and
anxiety experienced by people with TS.
Obsessive-compulsive
symptoms affect approximately half the population with
TS. Compulsions are repeated actions or behaviors that
a person feels he or she must do, usually in response
to a fear of unwanted consequences. These include checking
rituals, repeated touching, or hand washing. Obsessions
are recurring, unwanted thoughts or images that intrude
upon one's mind and interrupt schoolwork or other tasks.
Such thoughts are sometimes referred to as "mental
tics" and, in some ways, can be more distracting
than motor tics.
Related
Difficulties
TS
can cause difficulties for individuals that are separate
from the TS symptoms themselves. A person with TS may
feel tired from the physical exertion involved both
in expressing tics and in trying to suppress them. Some
of the medications used to treat severe tic symptoms
have undesirable side effects, such as sleepiness or
weight gain. A person with TS may be frustrated by not
having control over his or her own body. A child with
TS may be depressed because other children tease him
or her or react to his or her strange symptoms by excluding
that child. Children with TS may express their frustration
by acting out, which can further isolate them from their
peers. Many related difficulties are more profound when
the TS is accompanied by an associated disorder or disorders.
Cause
Research
has determined that TS is primarily an inherited disorder
that may be expressed in a child even if the parent
does not exhibit any symptoms. Genetic studies have
not found a single "TS gene" that causes the
disorder, so the pattern of inheritance may be complicated.
Studies have suggested that tics are caused by differences
in the neurotransmitter chemicals in the brain, specifically
a hypersensitivity to dopamine, the neurotransmitter
that carries messages about movement. Many researchers
are investigating the brain and genetic basis of TS,
so knowledge about the cause or causes of the disorder
is growing.
Treatment
While
there is no cure for TS, medications can decrease symptoms
of the disorder. The type of medication used depends
on the symptoms that are most troubling for a specific
individual and how that individual responds to the medications.
Medications differentially diminish tics, obsessions
and compulsions, anxiety, inattention, and hyperactivity.
However, side effects are likely, and adjustments to
the type of medications and dosage may be necessary
to find the right fit for the child.
Long
Term
While there is no cure for TS, the symptoms often become
less severe as individuals grow older. TS is NOT a degenerative
condition and is NOT
life-threatening. TS does NOT impair intelligence. Individuals
with TS live normal, healthy lives. People with TS are
in every profession and enjoy all kinds of recreational
activities.