Tourette Syndrome

What is Tourette Syndrome?

Tourette syndrome (also called tics syndrome) is a childhood-onset neuropsychiatric disorder, characterized by motor and vocal tics. Tics are defined as sudden, rapid, repetitive, non-rhythmic movements, gestures or vocalizations that mimic a behavior. This disorder was first described by Gilles de la Tourette. A person who has Tourette may be vulnerable to obsessive compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD) and mood disorders.

Types of tics

Children with Tourette syndrome may have one of two types of tics: movement tics and vocal tics.

Movement tics

Vocal tics

Eye blinking

Hiccuping

Head jerking

Yelling

Shoulder shrugging

Throat clearing

Eye darting

Barking

Finger flexing

Using different tones of voice

Sticking tongue out

Repeating one's own words or phrases

Touching nose

Repeating other's word or phrases

Smelling people

Using vulgar words or swear words

Obscene gesturing

 

Flapping the arms

 

Hopping

 

 

What are the symptoms of Tourette syndrome

Persistent motor and vocal tics may cause a broad range of distress and impairment. Some children may not have any distress or impairment, while for others, the impairment may be mild to severe. Younger children, in particular, may be unaware of their tics, so they suffer no distress, and show no impairment in any area of functioning. The most commonly associated symptoms are obsessions and compulsions along with hyperactivity, distractability, and impulsivity. Social discomfort, shame, self-consciousness and demoralization, and sadness occur frequently.

What causes Tourette syndrome?

The causes of Tourette syndrome are not known. However, experts say that the disorder can be caused due to:

  • Genetic conditions: Some abnormalities in genes may cause Tourette syndrome, though there is still research being conducted on the relationship between them
  • Brain abnormalities: Fluctuation of chemicals that transmit neuro impulses, including dopamine and serotonin

How is Tourette syndrome diagnosed?

The diagnosis of Tourette syndrome is done based on the perinatal history, early development, medical history and family history. A thorough clinical history and neurological examination are generally sufficient to screen for the evidence of a tic disorder.

The Yale Global Tic Severity Scale is used to rate the severity of the tics. The child is also assessed for comorbid disorders and a treatment plan is created based on the severity of the condition.

 

Treatment and support for Tourette syndrome

While there is no cure for Tourette syndrome, treatment involves helping the person with illness to cope with their daily activities. Medication is one of the main interventions for reducing tics. In cases where the tics aren't severe, experts suggest that treatment may not be necessary.

Some therapies that may be incorporated into the treatment for Tourette syndrome are:

  • Behavioral therapy: A form of behavior therapy called habit reversal therapy (HRT) helps children with Tourette syndrome. It involves training persons to recognize their uncomfortable urges and tics and perform a movement which is different from the tic, and learn to have their tics conditioned. The therapy involves self-awareness and self-monitoring, relaxation techniques, competing response training and contingency management.
  • For patients with comorbid symptoms of ADHD and OCD, medication and therapy are also suggested.

Caring for someone with Tourette Syndrome

Parents can assume that tic disorder is a form of attention-seeking behavior. Therefore, education of the child with illness and family members, and support from the doctor are important to manage Tourette syndrome effectively. Parents should maintain a supportive family environment and explain to the other family members about the behavior of the child. If there are signs of anxiety-inducing situations, suggest some relaxation techniques to the child.







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