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Tourette Syndrome |
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Definition
Gilles de la Tourette syndrome, also called simply
Tourette syndrome, is a disorder characterized by
multiple motor and vocal tics that begins before age
18.
Cause
Tourette Syndrome is
thought to have a genetic component. This means that
having a certain gene or mix of genes makes a person
likely to develop the condition. The exact gene or
genes have not been identified.
Symptoms
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This disease begins in childhood,
usually between the ages of 2 and15.
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The most common symptom is motor
tics (seen in about 80% of people with this
disease). Tics are quick jerky movements of
different parts of the body that can occur
separately or in rapid sequence.
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Motor tics can be very simple,
such as a jerking motion of the arm, or more
complex, such as frowning, shoulder shrugging, or
head thrusting.
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Sometimes, more harmful tics
(i.e., nail biting, hair pulling, or lip biting)
may be present.
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People with this disease often
feel a build-up of tension before they have their
tic, and feel better and more relaxed after the
tic has passed.
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These verbal ejaculations may
be simple, such as grunting, coughing, or barking.
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Others may have more complex
phonic tics, such as endlessly repeating words,
yelling profanity, repeating other's phrases, or
imitating their movements.
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People with this disease have a
higher rate of psychiatric disorders. For example,
obsessive-compulsive disorders are seen much more
often in people with Tourette's syndrome.
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There are also social issues that
people with this disease have to deal with, as the
tics often create uncomfortable situations for
them. They may yell things inappropriately, or have
jerking movements at very awkward times.
Screening and Diagnosis
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The symptoms usually suggest the
diagnosis.
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The physical examination is
usually normal.
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CT scans and MRI scans are normal
as well, and may not even need to be done.
Treatment
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This is a life-long disease, and
patients with it may have an up and down course.
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Medicine usually helps decrease
some of the symptoms.
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Haloperidol is the drug most
often used. The dose is adjusted according to
individual response.
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Other drugs that are sometimes
used include Clonazepam, Clonidine, Fluphenazine (Prolixin),
or Pimozide. Other drugs may also be tried, but
they have not been proven to be effective.
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Treatment is usually continued
for life.
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Some people with this disease may
temporarily control their symptoms. By yelling and
getting out their tensions, they can sometimes stop
their symptoms for a short time.
Complications
One of the most disabling aspects of Tourette syndrome
is the high rate of associated co-morbidities such as
obsessive-compulsive disorder, attention
deficit-hyperactivity disorder (ADHD), anger control
problems, and poor social skills. These problems need
to be identified and addressed accordingly.
Prevention
There is no known prevention.
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