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Tourette’s syndrome

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Tourette’s Syndrome (TS) is a genetic neurological disorder characterized by tics with onset in childhood. The tics present should comprise of at least two kinds. One affects the motor movement of the affected individual while the other affects the vocal region responsible for sound. Tics are described as repetitive involuntary movements or vocalizations. Tics may occur several times daily or intermittently over a few years. It is also possible for symptoms of the condition to disappear for several weeks or months before reoccurring. 1 out of every 1,000 Americans is diagnosed with the condition. The good news is that it is not life-threatening and does not lead to the development of other physical diseases.

The condition is also known as Tourette Syndrome, Tourette’s Disorder or Gilles de la Tourette Syndrome (GTS) which was discovered during the 19th century. Being a syndrome, it is characterized by a variety of symptoms. All persons with Tourette’s Syndrome have tics but it is possible for individuals to have tics without the condition. Before, it was considered a strange problem due to patients’ exclamation of obscene words which is a symptom known as coprolalia. It is now categorized under tic disorders with the inclusion of both transient and chronic tics. There are no true cures for the disorder but several approaches aim toward helping individuals cope with the symptoms.

TOURETTE'S SYNDROME SYMPTOMS

There are several symptoms associated with Tourette’s Syndrome but the most notable and common would be tics. More than one type of tic occurs at a time described as repetitive, involuntary, brief, unpredictable and purposeless movements or sounds created by the affected person. Some tics are not truly sudden in nature as in the case of freezing or holding a position for a short while. Coprolalia is another symptom from a complex vocal tic which is defined as sudden cursing or outburst of obscene language. Echolalia is also a vocal tic defined as repeating phrases or words said by other people.

Severity of the tics may vary ranging from barely noticeably to highly debilitating. Some children may manifest symptoms at an early age while others remain dormant and present only later on in adulthood. Common symptoms include eye blinking, grimacing, shoulder shrugging, head jerking, nose touching, throat clearing, tongue clicking, mild yelping and smirking. There are progressive symptoms that may be self-destructive such as head banging, eye poking, lip biting and sudden swirling or jumping about.

Other notable effects and behavioral changes include sleep problems, heat sensitivity, cold sensitivity, polydipsia or excessive water drinking, photosensitivity or irregular pupil dilation or contraction, tactile hypersensitivity, sudden itchy feeling, social withdrawal, depression, low self-esteem, feelings of going crazy, hopelessness, feelings of rejection, lack of understanding or focus and eating disorders.
tourettes syndrome
Image: Tourettes Syndrome

TOURETTE'S SYNDROME CAUSES

Tourette’s Syndrome is classified as part of a spectrum of tic disorders by the Diagnostic and Statistical Manual of Mental Disorders or DSM. The tics are classified according to motor or phonic type and transient or chronic duration. The exact cause of the disorder is not known although experts believe that hereditary and environmental factors play a huge role in its development. There is a 50% possibility that a person diagnosed with the condition will pass on the genes to his or her offspring. It is possible for someone to be a gene carrier without manifesting any symptom. According to studies, males are also more likely to express symptoms compared to females.

Other psychological conditions like obsessive-compulsive disorder or OCD, attention-deficit-hyperactivity disorder or ADHD and other impulsive, learning and behavioral disorders are also associated with the development of Tourette’s Syndrome. In some cases, psychosocial factors, infection and autoimmune responses may also possibly trigger the condition. Almost all cases begin before the age of 18 years old.

TOURETTE'S SYNDROME TREATMENT

There is no universal treatment approach to Tourette’s Syndrome since it is comprised of different symptoms at varying degrees. A sound method would involve reducing the symptoms to manageable levels and keeping the patient comfortable and able to cope with normal activities. Pimozide, olanzapine or haloperidol are neuroleptic medications that can reduce tics. Paroxetine helps reduce tics as well as alleviates feelings of anxiety. This is especially helpful if the patient is also diagnosed with obsessive-compulsive behavior. Clonidine is an antihypertensive drug used to treat high blood pressure, reduce tics and improve ADHD symptoms. Antidepressant drugs like fluoxetine, fluvoxamine and sertraline may also be prescribed. Take note that these medications also come with side effects such as dizziness, nausea, drooling, weight gain, irregular bowel movement and fatigue.

There is no cure for Tourette’s syndrome but most cases are very mild and often do not require pharmacological treatment. Patients may also learn adaptive skills through education, psychotherapy, behavioral therapy and counseling. Stress reduction techniques, healthy eating habits, well-rounded social life, adequate rest and regular exercise are also very effective in making the disorder manageable. Find activities that the patient prefers and always reinforce and reassure wellness through a reliable support system like family and friends.

Since the condition is highly believed to stem from genetic and environmental processes, it is best to follow preventive approaches revolving around these areas. Family planning is a very good option since parents can discuss their tendency to bear children having the disorder or the possibility of passing on bad traits. People should check their background by assessing for members who may have manifested symptoms including mild ones.


Assessment of children ages 4 to 5 years old will also help determine whether they are afflicted with the condition. Knowing about the disorder early on will help find means to alleviate the problem as well as develop coping skills should symptoms remain for the long term. Patient education is very important so that the person will know how they can possibly pass on or acquire Tourette’s Syndrome.

For TS associated with other psychological or behavioral problems, it would be best to avoid or alleviate the underlying conditions as well. Maintaining a secure and emotionally steady environment for growing children and even mature individuals will greatly help create a sense of well-being and boost self-esteem. Adjusting well mentally, physically and emotionally in a given area together with an effective support system will help prevent the occurrence of mental and behavioral disorders that may also lead to Tourette’s Syndrome.
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