Tourette syndrome (TS) is a type of neurological disorder that is characterized by involuntary repetitive muscle movements and vocalizations called tics. The first symptom of this syndrome may occur between ages 2-15 years.
There is no cure for Tourette syndrome, but treatments are available to reduce the symptoms . Tics reduce after the adolescent age in most children, and only those with severe symptoms need treatment. Parents must understand the disease and take precautions at the early stage to reduce the impact of tics. Sometimes tics will disappear after treatment and will never occur again.
What is Tourette Syndrome?
Tourette syndrome is a condition that causes people to have tics. Sudden twitches, bodily movements, and sounds that people get repeatedly and uncontrollably are termed as tics. Tics are similar to hiccups. It is an involuntary body movement that is hard to control. Tics are classified into vocal and motor.
Tics are also classified as:
● Simple tics. These tics are sudden, brief and repetitive which involve only a limited number of muscle groups.
● Complex tics. These tics are distinct, coordinated patterns of movements that involve several muscle groups.
However, the spectrum of tics that people experience is diverse. For example, the person will be doing involuntary actions like blinking eyes again and again or shrugging shoulders or making a grunting sound. Though they do not want to do it, their body cannot stop it. They can control it a little but cannot prevent it.
Symptoms of Tourette Syndrome
Based on the age and other related factors, the disease can be mild to severe in individuals.
Tics interfere with your daily routine and interfere with the normal life of the patients. Vocal Tics and Motor tics are the two types of tics.
1. Motor tics: Motor tics are the bodily movements that occur spontaneously, and sometimes the body movements like facial grimacing may be simple or combined. The movements of the body like jerking an arm or head, shrugging the shoulder, nose twitching, darting eyes, and blinking are called motor tics.
2. Vocal tics: The sounds like clearing the throat, humming, or yelling out words are vocal tics.
Tics may be simple or complex. Simple tics like facial grimacing are small actions that reduce after a short period and are often less noticed by others. Complex tics are a group of tics that affect the behaviour of the patient. They may start to use vulgar and obscene words repeatedly and create a hypothesized situation.
Tics can be mild or severe based on the individual. Some tics are very simple like sniffing, squinting the eyes, twitching the nose, clearing the throat and they will not feel bad doing these.
Complex tics like using vulgar words and obscene words repeatedly, moving in a certain pattern, smelling objects, and bending down are more severe forms of tics and need immediate care and treatment.
Complications with Tourette Syndrome
Tourette syndrome is not a racial or ethnic disease, but there are more chances of it being a hereditary disease. It does not affect the life of the patient but leads to social and behavioural changes. Behavioural changes affect the self-esteem of the patient and make them stressed and depressed.
The disorders that may be associated with this syndrome are
● Depression.
● Sleeping disorder.
● Anxiety.
● Obsessive-compulsive disorder (OCD).
● Attention deficit hyperactivity disorder (ADHD).
● Tics associated muscle-pain and headache.
Risk factors for Tourette Syndrome
● Sex: Tourette syndrome is more common in males, and females are less likely (less than 20%) to develop disorders with tics. The boy child receives the gene from the parents, and the rate of expression of this dominant gene is 400% more than the girl child.
● Hereditary: Tourette syndrome may be transferred from the parents to children through genes. TS dominant has more than 50% chance to be transferred to the male children from TS parents.
● Some studies have found that environmental factors like pregnancy complications, low birth weight, or smoking during pregnancy increase the chance of TS.
Treatment of Tourette Syndrome
There is no cure for this syndrome. However, some medicines and therapies were found to reduce the effects. The medicines are prescribed to reduce the impact of severe tics. Treatment is not necessary for mild tics.
Medication for Tourette syndrome
The following medicines are found to reduce symptoms of Tourette syndrome:
1. Medications that block or lessen dopamine. Fluphenazine, Haloperidol , Risperidone and Pimozide can help control tics.
2. Botulinum (Botox) injections. This injection administered into the affected muscle may help in relieving a simple or vocal tic.
3. ADHD medications. Stimulants, such as Methylphenidate and medications containing Dextroamphetamine can help in increasing attention and concentration. But, for few people with Tourette syndrome, medicines for ADHD can exacerbate tics.
4. Central adrenergic inhibitors. Medicines, such as Clonidine and Guanfacine (prescribed typically for high blood pressure) may help in controling behavioral symptoms like rage attacks and impulse control problems.
5. Antidepressants. Fluoxetine may help in controlling symptoms of OCD, anxiety and sadness.
6. Antiseizure medications. Recent studies suggest that some people with Tourette syndrome respond to topiramate, which is used to treat epilepsy.
Therapy for Tourette Syndrome
● Behavioural therapy: Behavioural therapy treatments like habit reversal, parent training, and comprehensive behavioural intervention for tics (CBIT) are found to be helpful to reduce the severity of tics. Behavioural therapy treatments reduce the severity of tics, the number of tics, and its impact to a greater percentage.
● Habit reversal: This is one of the best treatments for reducing tics. Psychiatrists provide awareness training and response training to identify the tics and reduce the impact.
● Parent training: Parent training is another effective method to reduce tics amongst children. This helps parents understand their child’s condition and help them to reduce the severity of tics. In this training, parents are taught to use positive enforcement and discipline their children when necessary.
Frequently Asked Questions (FAQs)
● What age do Tourette’s syndrome symptoms begin?
Tourette syndrome symptom begins at an early age of 2. For some kids, it may show its first symptom at the age of 12. The average age for children to start manifesting symptoms is 6 years.
● How serious is Tourette’s syndrome?
Globally, more than 1% of children and youngsters are affected by this syndrome. Tourette’s syndrome creates involuntary bodily movements and vocalizations and affects the self-esteem of the individual. Involuntary bodily movements are harmful to the patients, and severe vocal tics create turmoil in their minds causing depression .
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