What is Tourette Syndrome: Symptoms and Causes

Tourette syndrome is doing repeated movements or making unwanted sounds that can’t be easily controlled. For example, blinking eyes repeatedly, shrugging the shoulders or blurt out unusual sounds (tics).

They show up usually between the ages 2 and 15. Males are about 3 to 4 times more likely to develop Tourette syndrome.

There are some treatment methods available to reduce the repetitiveness but there is no complete cure. Tics often decrease after attaining puberty.

Sudden, brief, intermittent movements or sounds also known as tics, are the characteristic symptoms of Tourette syndrome. Tics are classified into simple tics (involves limited number of muscle group) and complex tics (involves several muscle groups). Tics can also be differentiated into motor tics or vocal tics. Motor ticks usually precede vocal tics.

Some of the common motor tics include:

• Simple tics ( eye blinking, head jerking, shoulder shrugging, eye darting, nose twitching and mouth movements).
• Complex tics (touching or smelling objects, repeated observed movements, stepping in a certain pattern, obscene gesture, bending or twisting and hopping).

Examples of vocal tics include:

• Simple tics (grunting, coughing, throat clearing and barking)
• Complex tics (repeating one’s own words or phrases, repeating other’s words or phrases, using vulgar, obscene or swear words).

Additionally, tics can vary in type, frequency and severity; worsen with illness, stress or anxiety, can occur in sleep, change with time and improve during transition into adulthood.

Sometimes, the repeated movements are preceded by uncomfortable bodily sensations like itching or tingling.

Tourette syndrome is a complex disorder which is likely to be caused by a combination of hereditary and environmental factors. But, the exact cause is unknown.

Dopamine and serotonin are the chemicals that transmit nervous impulses in the brain. Disorders in these chemicals may lead to such disease.

The diagnosis of Tourette syndrome is mostly based on history of illness. The criteria used to diagnose Tourette syndrome include:

• Both motor tics and vocal tics are present.
• Tics occur several times a day.
• Illness is present for more than a year.
• Tics began before 18 years of age.
• The repetitive movements are not caused by medications or other substances.

To rule out other conditions, some additional tests may be done like blood tests and Imaging tests such as MRI.

There is no cure for Tourette syndrome but some treatments are available like:

Medications:

• Drugs that block Dopamine, Fluphenazine, Haloperidol and Pimozide can control tics. Some common side effects are involuntary repetitive movements and weight gain.
• Botulinum Injections- an injection is given to the affected muscle to relieve tics.
• ADHD Medications- Methyphenidate and medications containing Dextroamphetamine can help increase attention and concentration. In some people, these medications can increase tics.
• Central Adrenergic Inhibitors- medications such as choline and guanfacine might help in controlling behavioral symptoms such as impulse control problems.
• Antidepressants- Flouxetine may help in controlling sadness.
• Anti-seizure Medications- Topiramate which is used to treat epilepsy can be useful in Tourette syndrome.

Therapy:

• Behavior Therapy- cognitive behavioral intervention, habit reversal training can help to monitor tics, identify premonitory urges and learn to voluntarily move in a way that is incompatible to tics.
• Psychotherapy- this can help with associated problems such as ADHD, obsessions, anxiety or depression. DBS- this kind of therapy is used when a person doesn’t respond to any other therapy. It includes implanting a medical device in the brain to deliver electrical stimulation to control movements.

This Tourette syndrome cannot be prevented since the cause is yet unknown.

No alternatives or homeopathic remedies can treat Tourette syndromes.

Lifestyle modifications are necessary in order to cope with Tourette syndrome.

Severe harm to self-esteem is the result of Tourette syndrome. People may get embarrassed about tics and may not engage in social activities. Depression and substance abuse may be sought after.

To cope with Tourette syndrome, it is important to reach out to others to seek help and gain information about this disorder.

If a child is suffering from Tourette syndrome, following measures must be taken: being child’s advocate- educating teachers, school bus drivers and other children about this syndrome.

Increase child’s self-esteem- supporting the child’s personal interests and friendship can help build self-esteem. Finding support groups- seek help of a local Tourette syndrome support group.

There are several risks and complications associated with Tourette syndrome.

The factors that can increase the risk of Tourette syndrome are:

• Family history- genetics most probably play an important role in this disorder.
• Sex- males are about 4 times more likely to be affected.

In some cases, people with mild and simple tics may lead a healthy life without any requirement of treatment.

But in other cases, Tourette syndrome involves social or behavioral movements which may affect the person mentally.

The following complications may develop like:

• Attention-deficit/hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• Autism spectrum disorder
• Learning disorders
• Sleep disorders
• Depression
• Anxiety
• Pain related to tics and anger management problems