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CNI Movement Disorders Center
Education & Information
Facts about Tourette Syndrome
Tourette Syndrome (TS) is a neurological disorder characterized by motor, vocal or phonic tics. These symptoms usually appear during childhood and often are accompanied by obsessive-compulsive disorder (OCD), attention deficit-hyperactivity disorder (ADHD), poor impulse control, and other behavioral problems. TS is recognized as a relatively common and complex neurobehavioral disorder.
Cause
The cause of TS is unknown, but the disorder appears to be inherited in the majority of patients. Diagnosing TS requires a careful evaluation of the patient's symptoms and signs by an experienced clinician. While diagnosis and awareness of the disorder has improved, many patients remain undiagnosed or their symptoms are wrongly attributed to habits, allergies, asthma, dermatitis, hyperactivity, nervousness and many other conditions.
Signs and Symptoms
Tics can typically be categorized into various types. With each, the specific movements may become worse when the patient is under stress.
Motor Tics: These are abrupt, brief, rapid and repetitive movements that may fluctuate in distribution and severity. Common motor tics include eye blinking, eye deviation, facial grimacing, neck popping and/or stretching and shoulder shrugging. Simple motor tics involve repetitive movement of one muscle group such as shoulder shrugging, eye blinking or neck popping. Complex motor tics include coordinated motor behaviors such as touching, tapping, jumping, skipping when walking, or socially inappropriate gestures.
Vocal or Phonic Tics: These types of tics causing noise or sound. Simple tics include sniffing, coughing, grunting, guttural maneuvers, inhaling, screaming, sniffing and squealing. Coprolalia, which is characterized by the shouting of obscenities or profanities, is probably the most over-emphasized symptom of TS, and is actually present in only about a third of all patients. Other complex phonic tics include palilalia (repetition of the last syllable, word or phrase in a sentence) or echolalia (repetition of someone else's words or phrases).
Patients with TS often say that tics are preceded by a feeling that is similar to “needing to stretch the muscle,” increased tension or discomfort After performing the tic, then patients can have a temporary sense of relief. Patients that try to suppress their tics usually have an increase in frequency of tics after the patient stops suppressing them.
Treatments
Different treatments can be given for OCD, attentional problems and the tics. The choice of treatment is individualized to the patient. Some people do not require symptomatic treatment if the symptoms do not interfere with daily activities
Treatment of ADHD includes behavioral modification, school and classroom adjustments and stress management. Some medications may be required when behavioral measures are ineffective. Educating parents, teachers, school administrators as well as health care professionals is crucial in early recognition of symptoms, confirming a diagnosis, and initiating appropriate treatment.
Surgical therapy using deep brain stimulation (DBS) may be considered in severe cases. Treatment program should be a team approach which includes a physician, psychiatrist, social worker and other allied health professionals.
For more information about TS, please contact www.tsa.org/usa or www.wemove.org.
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