Tourette Syndrome (TS) is a neurological disorder characterized by repetitive, involuntary movements and vocalizations called tics.
Causes and Risk Factors
The exact cause of TS is unknown, but current research suggests there are abnormalities in certain brain regions (including frontal lobes and cortex), the circuits that interconnect these regions, and the neurotransmitters that are responsible for communication among nerve cells. Since TS is a complex disorder, the cause is likely to be just as complex.
The early symptoms of Tourette syndrome are typically noticed in childhood at ages 7 to 10. Tourette syndrome occurs in people from all ethnic groups and affects males three to four times more often than females. About 200,000 Americans have the most severe form of TS, and as many as 1 in 100 have milder and less complex symptoms such as chronic vocal tics. Most people with TS experience their worst symptoms in their early teens with improvement in their late teens and continuing into adulthood.
Symptoms
The tics associated with TS are classified as either simple or complex.
Simple Tics- Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups.
Some common simple tics include:
- Eye blinking and other vision irregularities
- Facial grimacing
- Shoulder shrugging
- Head or shoulder jerking.
Simple vocalizations might include:
- Repetitive throat-clearing
- Sniffing
- Grunting sounds
Complex Tics– Complex tics are distinct, coordinated patterns of movements that involve several muscle groups.
Complex motor tics might include:
- Facial grimacing combined with a head twist and a shoulder shrug
- Sniffing or touching objects
- Hopping
- Jumping
- Bending
- Twisting
Complex vocal tics include words or phrases. The most disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia, which is when one utters swear words, or echolalia, which is the repetition of others’ words or phrases. Some tics are preceded by an urge or sensation in the muscle group affected, which is commonly called a premonitory urge.
Tests and Treatment
Doctors can diagnose TS after verifying that the patient has had both motor and vocal tics for at least 1 year. If the patient has any other neurological or psychiatric conditions (such as behaviors found in autism or obsessive-compulsive disorder), doctors can make a diagnosis with much more ease.
Tic symptoms do not often cause impairment, so the majority of people with Tourette syndrome do not require any medication for tic suppression. However, there are effective medications available for those whose symptoms interfere with everyday normal functions. Neuroleptics are the most consistently useful medications for tic suppression.
Unfortunately, there is no one medication that is helpful to all people with TS. There also is not a medication that will completely eliminate symptoms. All medications have side effects. The most common side effects of neuroleptics include sedation and weight gain.
To learn more about TS, you can visit www.tsa-usa.org or www.tourettesyndrome.net
