Tourette’s Disorder also called Tourette Syndrome (TS) is a complex medical condition and according to the Tourette Syndrome Association, can be described as “a movement disorder, neurological condition, or a neuro-psychiatric condition.” Those affected with Tourette Syndrome display tics – movements and verbal utterances that are difficult or impossible for them to control.
The tics (movements and sounds) associated with Tourette’s Disorder are typically first seen at around the age of seven and while the severity of symptoms may decrease toward the end of adolescence, it is likely that people with Tourette Syndrome will experience symptoms all throughout their lives. Typically, rapid blinking or twitching of the mouth are the first indicators, but TS may begin with sounds such as sniffling or throat clearing. Severity and frequency of tics can vary, not only from person to person, but also in each individual case. A person with Tourette’s Disorder cannot control their symptoms, but they may find them to be more severe in stressful, anxiety provoking situations.
Movements and Sounds of Tourette’s Disorder
The movements and sounds associated with TS can vary from mild to quite disruptive and the unpredictable nature of the symptoms can make even friends and close acquaintances of people with TS question the validity of the involuntary aspect of symptoms. Nonetheless, it is unreasonable and unfair to expect that someone with Tourette’s Disorder hold back their outbursts since they in fact cannot exert any control over them. At best, tics can sometimes be temporarily suppressed, but must eventually be displayed.
Movements typical to TS include, on the mild side, eye blinking, shrugging of the shoulders, head jerking and facial grimacing. More extreme movements can include jumping, smelling, twirling, touching other people and even hitting or biting oneself.
Sounds vary, too, and range from throat clearing, yelping, sniffling, and clicking of the tongue, while some people with TS exhibit more complex sound tics. Echolalia, the repeating of a just heard sound, word, or phrase is not uncommon, which can make those unfamiliar with a person’s condition feel that they are being mocked. Another sound tic is called coprolalia, which is the uttering of words or phrases that may be inappropriate to the situation, this can also include swearing or saying socially inappropriate things, which many people falsely believe is the most common symptom associated with Tourette’s Disorder. The tendency of movies and television shows to focus on this particular tic may have given the public the assumption that it is common amongst those with TS, but in reality, only affects 10-15% of those afflicted.
Causes and Diagnosis of Tourette’s Disorder
There is a clear genetic link in incidence of TS, although not all people with Tourette Syndrome are aware of any family history. Those with TS have a 50% chance of passing the gene that carries TS along to each of their children. It is suspected that multiple genes may be involved, but only one has been positively identified, thus far. There is also some speculation that streptococcal throat infections (strep throat) may trigger TS in some people, but this is yet unproven.
TS is diagnosed by a thorough evaluation of symptoms, with the requirement that at least one sound tic must be present, along with several movement tics. A series of physical tests including blood work, EEG, CT scans, and MRIs may be employed to rule out other conditions, so making a determination of Tourette’s Disorder ultimately comes down to assessing symptoms.
While there is currently no known cure for TS, those who find their symptoms to be extremely intrusive may wish to try medication to suppress tics, although unpleasant side effects may make medication a last resort for many. Relaxation techniques may be helpful in lessening the severity of tics for some people, and some behaviour therapies can teach those with TS to substitute one tic for another, less socially acceptable one.
Treatment should begin as early as possible because children with TS may be teased, bullied, or even ostracised by other children, making it difficult for them to function socially. As adolescence approaches, a time of confusion and uncertainty for even kids without TS, the importance of healthy socialisation becomes even more important.
Kids with TS, although just as intelligent as their peers, may experience some learning difficulties, requiring special educational help. If reading or writing problems are present, the use of tape recorders or computers may be beneficial. Encouragement and emotional support from parents and other family members is crucial for kids with Tourette’s Disorder, helping them to establish a healthy sense of self-esteem and worth.