Tourette's Syndrome

Georges Gilles de la Tourette

French neuropsychiatrist who first assessed the syndrome in late 1800s.

What is Tourette Syndrome?

Tourette Syndrome (TS) is a neurological disorder characterized by tics -- involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way.

The symptoms include:

1. Both multiple motor and one or more vocal tics present at some time during the illness although not necessarily simultaneously
2. The occurrence of tics many times a day (usually in bouts) nearly every day or intermittently throughout a span of more than one year; and

3. Periodic changes in the number, frequency, type and location of the tics, and waxing and waning of their severity. Symptoms can sometimes disappear for weeks or months at a time.

4. Onset before the age of 18.

The term, "involuntary," used to describe TS tics is sometimes confusing since it is known that most people with TS do have some control over their symptoms. What is not recognized is that the control, which can be exercised anywhere from seconds to hours at a time, may merely postpone more severe outbursts of symptoms. Tics are experienced as irresistible and (as with the urge to sneeze) eventually must be expressed. People with TS often seek a secluded spot to release their symptoms after delaying them in school or at work. Typically, tics increase as a result of tension or stress, and decrease with relaxation or when focusing on an absorbing task.

http://www.mrindianajones.com/images/tourette/tourette_logo.jpg

Demographics

TS does not discriminate between races as for all ethnic groups are able to develop symptoms, but it is sexist because males are 3 4 more times likely to develop symptoms of Tourette Syndrome than females. In the United States about 1 in every 200 people have some form of TS.

Stereotypes

Coprolalia - Vocal tics that include obscene and socially inappropriate words or phrases. The media has distorted this image and in all reality only about 15% of individuals with TS exhibit coprolalia.

Tics of TS

There are two types of tics for TS: motor, which are physical movements, and vocal/phonic, which are emitted sounds or vocalizations. These are broken down into three categories based on severity. Simple, Complex, and Internal.

This link provides a great overview of Tourette's and its tics.

http://www.tourettesyndrome.net/Files/Tourette_Primer2004.pdf

Diagnosis

A diagnosis is made by observing symptoms and by evaluating the history of their onset. No blood analysis or other type of neurological testing exists to diagnose TS. However, some physicians may wish to order an EEG, MRI, CAT scan, or certain blood tests to rule out other ailments that might be confused with TS. Many other disorders are often found in individuals who have TS which can complicate both diagnosis and treatment. Other disorders often associated with TS include: ADD/ADHD, Obsessive Compulsive Disorder, Sleep Disorders, Impulse Control Problems, and other Learning Disabilities.

Treatment

The majority of people with TS are not significantly disabled by their tics or behavioral symptoms, and therefore do not require medication. However, there are medications available to help control the symptoms when they interfere with functioning. Other types of therapy may also be helpful. Psychotherapy can assist a person with TS and help his/her family cope, and some behavior therapies can teach the substitution of one tic for another that is more acceptable. The use of relaxation techniques and/or biofeedback can serve to alleviate stress reactions that cause tics to increase.