Tourette Syndrome

 

What is Tourette syndrome? Tourette Syndrome (TS) is a neurological disorder characterized by tics -- involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way. Diagnostic criteria include: Both multiple motor and one or more vocal tics present at some time, although not necessarily simultaneously; The occurrence of tics many times a day (usually in bouts) nearly every day or intermittently throughout the span of more than one year; Periodic changes in the number, frequency, type and location of the tics, and in the waxing and waning of their severity. Symptoms can sometimes disappear for weeks or months at a time; Onset before the age of 18. Although the word "involuntary" is used to describe the nature of the tics, this is not entirely accurate. It would not be true to say that people with TS have absolutely no control over their tics, as though it was some type of spasm; rather, a more appropriate term would be "compelling." People with TS feel an irresistable urge to perform their tics, much like the need to scratch a mosquito bite. Some people with TS are able to hold back their tics for up to hours at a time, but this only leads to a stronger outburst of tics once they are finally allowed to be expressed. Although the DSM-IV has recently changed the upper age of onset from 21 down to 18, the Tourette Syndrome Association Medical Advisory Board is working to have it reverted back to 21, as is listed in the DSM-III-R. Coprolalia (see below) does not have to be exclusively swear words. Many times coprolalia manifests itself as socially inappropriate or unacceptable words or phrases, such as the overwhelming urge to use a racial epithet, even though that is the last thing you want to do. Something about the "forbiddenness" of it impells a person with coprolalia to say it, seemingly against their will. Another important thing to remember about coprolalia is that although this symptom has been sensationalized by the media, it is actually rare, occuring in less than 30% of people who have a severe case. Simple tics are movements or vocalizations which are completely meaningless, whereas complex tics are movements or vocalizations which make use of more than one muscle group or apear to be meaningful. The range of tics or tic-like symptoms that can be seen in TS is very broad. The complexity of some symptoms is often perplexing to family members, friends, teachers and employers who may find it hard to believe that the actions or vocal utterances are not deliberate. List of symptoms (Tics) Tourette (TS) Syndrome is a neurological disorder characterized by tics -- involuntary, rapid, sudden movements that occur repeatedly in the same way. To receive a diagnosis of TS a person must have both multiple motor and one or more vocal tics, not necessarily simultaneously, throughout a span of more than one year. The tics may occur many times a day (usually in bouts) nearly every day or intermittently. Tics periodically change in the number, frequency, type and location and wax and wane in their severity. Symptoms can sometimes disappear for weeks or months at a time. While most persons with TS have some control over their symptoms from seconds to hours at a time, suppressing them may merely postpone more severe outbursts. Tics are experienced as irresistable and (as the urge to sneeze) eventually must be expressed. Tics increase as a result of tension or stress and decrease with relaxation or concentration on an absorbing task. Tics are categorized as Motor or Vocal, Simple or Complex. Simple tics are movements or vocalizations which are completely meaningless, whereas complex tics are movements or vocalizations which make use of more than one muscle group or appear to be meaningful. Simple Complex M O T O R Abdominal jerking Ankle flexing Arm flailing Arm flapping Arm flexing Arm jerking Arm squeezing Clapping Eye blinking Eye rolling Facial contortions Foot dragging Foot shaking Foot tapping Grimacing Hair tossing Head jerking Knee bending Knee knocking Leg jerking Licking Lip smacking Mouth opening Nose twitching Pouting Shrugging Squatting Squinting Stomping Stooping Tongue thrusting Banging Body jerking Body slamming Chewing clothes *Copropraxia *Echopraxia Hair twisting Hitting Hopping Jumping Kicking Kissing Picking Pinching Pulling clothes Skipping Scratching Shivering Smelling things Somersaults Stepping backwards Tearing things Throwing things Twirling in circles Walking on toes V O C A L Belching Clicking Coughing Gasping Grunting Gurgling Gutteral sounds Hiccupping Hissing Honking Misc. noises Moaning Noisy breathing Puffing Screaming Shouting Sniffing Snorting Squeaking Squealing Sucking Throat clearing "Tsk," "Pft," etc. Yelping Amplitude of speech Animal sounds -- cow, dog, etc. Barely audible muttering Calling out *Coprolalia *Echolalia "Hey," "Wow," etc. Humming Laughing *Palilalia Repeating parts of words Repeating phrases Repeating words Spitting Stuttering Talking to oneself Whistling Yelling   *Copropraxia: Making obscene gestures. *Echopraxia: Mimicking movements that others make. *Coprolalia: Vocalizing obscene or other socially unacceptable words or phrases. *Echolalia: Repeating what someone else just said. *Palilalia: Repeating your own words over and over again   Research is ongoing, but it is believed that an abnormal metabolism of the neurotransmitters dopamine and serotonin are involved with the disorder. It is genetically transmitted; parents having a 50% chance of passing the gene on to their children. Girls with the gene have a 70% chance of displaying symptoms, boys with the gene have a 99% chance of displaying symptoms. People with TS are more likely to have any combination of the following problems: Attention-Deficit/Hyperactivity Disorder (ADHD) Difficulties with Impulse Control (disinhibition) Obsessive-Compulsive Disorder (OCD) Various Learning Disabilities (such as dyslexia) Various Sleep Disorders Back once again to the DSM-IV, Tourette Syndrome is an Axis I disorder. People with TS do tend to present with more other Axis I disorders than the rest of the general population.   If you google Tourette syndrome, there is a host of information from whether it is inherited, how it starts, etc.