Tourette syndrome (TS) is a neurodevelopmental disorder that involves uncontrollable repetitive tics. These tics have repetitive motor movements and at least one vocal or phonic sound. The condition generally begins in childhood or early adolescence.
The most common tics in Tourette’s involve blinking, sniffing, facial movement, muscle twitching, coughing, throat clearing, or yelling out a word or phrase. After these tics, a person may feel premonitory urges to adjust the muscles. Tics are involuntary, and people cannot stop doing these movements. These tics can be simple or complex. Simple tics affect only a few parts of the body, such as sniffing or squinting eyes. Typically, complex tics involve multiple body movements with a characteristic pattern, such as muscular tics associated with phonic tics.
Symptoms of Tourette syndrome
The symptoms of Tourette syndrome are typically first noticeable during childhood or adolescence. Symptoms can vary from person to person. Mostly, tics become milder with time. Following are the symptoms of the Tourette syndrome one can experience:
- Variety of motor tics:
- Frequent eye blinking
- Facial grimace
- Head and shoulder wiggling
- Involuntary arm movements
- Mouth twitching
- Jerking muscular spasms
- Complex tics involving multiple muscles, such as jumping, spinning or kicking
- Vocal or phonic tics:
- Throat clearing
- Repeating own word (palilalia)
- Involuntary use of offensive language (coprolalia)
- Sometimes children or adults have other learning or behavioral difficulties, including obsessive-compulsive disorders (OCD), dyslexia, or hyperactivity.
- A person with Tourette syndrome may develop apprehension and anxiety due to their body movements.
The tics can vary in severity, frequency, and types. The symptoms worsen and last longer if you become ill, tired, anxious, stressed, or excited (tics triggers).
Causes of Tourette syndrome
The exact cause of this complex neurological disorder is unknown. But, according to some researchers, this problem happens due to disturbance in different parts of the brain which control our body movements (cortex, basal ganglia, and frontal lobes), the circuits that connect these regions, and the neurotransmitters. The precise reason which causes connection problems in our brain is still unknown, but some factors play a role in developing Tourette syndrome, including:
- Genetics: If a family member has Tourette syndrome, there are more chances of getting the disorder. Sometimes this condition can happen during the development of a fetus in the womb.
- Childhood illness: Infection with group A streptococcal bacteria can trigger Tourette syndrome in children.
- Some neurological conditions: Parkinson’s disease and Huntington’s disease, affect the basal ganglia, which can trigger tics.
Complications of Tourette syndrome
Normally, people with Tourette syndrome don’t have any physical symptoms and can live a normal healthy life. However, some behavioral and social challenges associated with Tourette syndrome can harm self-confidence. Some complications and conditions are often associated with Tourette syndrome, such as:
- Learning disabilities
- Anxiety and depression
- Tics-related pains in muscles and headaches
- Anger-management issues
- Obsessive-compulsive disorder (OCD)
- Autism spectrum disorder
- Attention-deficit/hyperactivity disorder (ADHD)
Diagnosis of Tourette syndrome
There is no specific test available to diagnose the condition, but the doctor can identify Tourette syndrome based on the symptoms. The following criteria must be present to confirm the Tourette syndrome:
- Presence of two or more motor tics and at least one vocal tic
- The person may experience these tics for at least a year. Although, the frequency may vary
- These tics must begin before the age of 18 years.
- These symptoms are not due to any drugs or any other medical conditions (vision problem, restless leg syndrome, Huntington’s disease, seizures, or post-viral encephalitis)
Blood tests, eye tests, skin tests, and imaging tests help rule out other possible similar medical conditions.
Treatment of Tourette syndrome
Generally, mild tics don’t need any medical intervention. If tics cause hindrance in daily activity, your healthcare provider may prescribe medications and therapy to relieve the condition. Following are some treatment options:
- Medications: Drugs help control tics and other symptoms related to the conditions. These medicines include dopamine blockers, antidepressants, antiseizure drugs, muscle relaxants, antihypertensive, or central adrenergic inhibitors. These drugs are beneficial in controlling tics, anxiety, and behavioral symptoms.
- Therapy: Person with Tourette syndrome also experience emotional, psychological, and behavioral issues. Following treatment modalities may help in these situations:
- Psychotherapy: It can help cope with mental stress and other related issues, including ADHD, depression, or anxiety.
- Behavioral therapy: With the help of cognitive behavioral intercession (habit reversal training), you can identify premonitory urges and adjust yourself in a way that resists them.
- Deep brain stimulus (DBS): It can help in severe cases of tics. The procedure involves implanting a battery-operated device in the brain, which delivers electrical stimulation to movement controlling areas.
- Surgery: The doctor recommends surgery in adults suffering from severe symptoms unresponsive to other treatment modalities.
The symptoms of Tourette syndrome are manageable with the help of some engaging activities and avoiding tics triggers. If any of your loved ones or other person is suffering from this disease, try to be supportive and help them.