Tourette's Syndrome

What is Tourette’s syndrome?

Tourette’s syndrome is a type of tic disorder. Tics are uncontrollable movements or involuntary sounds made by a person which is usually caused by some issue in the nervous system. Tic disorders such as Tourette’s syndrome are generally childhood-onset neurodevelopmental issues. Tic disorders are of  3 types – Tourette’s syndrome , Chronic Tic Disorder, and Provisional tic disorder. Tourette’s syndrome is defined as a tic disorder with involuntary movements (motor). Chronic tic disorder could be either motor or vocal. And Provisional tic disorder comprises of both types of tics. 
 
Tourette’s syndrome is said to onset when an individual has experienced at least 2 motor tics and 1 vocal tic within one year. Chronic Tic disorder patients show only one type of tic for a longer period of time. Provisional tic is supposed to occur if there are tics but for a shorter duration of time. 
 
People with Tourette’s may seek a secluded spot to release their symptoms, or there may be a marked increase in tics after a period of suppression at school or at work. 
 

What are the main signs and symptoms of this condition?

These are the main symptoms exhibited by a person with Tourette’s syndrome :
 
Physical tics can manifest in the form of 
– Blinking
– Eye rolling
– Sudden jerks in limbs
– Shrugging shoulder
– Jumping
– Twirling
– Touching other people 
 
Vocal tics can be seen in the form of 
– Unexplained coughing
– Grunting
– Whistling
– Clicking noises
– Animal sounds
– Saying words involuntrailty
– Repeating a sound/phrase
 
The severity and frequency of these tics can vary and generally tend to be high during 
 
– Fatigue
– Illness
– Anxiety
– Stress
 
People with Tourette’s syndrome can also show behavioral symptoms such as 
 
– Antisocial mannerisms
– Episodes of sudden rage
– Socially inappropriate behavior
 
Individuals with Tourette’s syndrome often get a feeling or a sensation much like the one gets before sneezing, just before they experience a tic. These can be in the form of :
 
– Burning sensation in the eyes
– Sore throat
– Itchy feeling in the joints
 
In some cases these tics can be controlled, but it can get exhausting trying to control or limit them. With concentration and practice it is possible to control tics to some extent. The frequency of these tics reduce if the individual is engrossed or engaged in some activity like reading a book.  Children may be less aware of the premonitory urge associated with tics than are adults, but their awareness tends to increase with maturity. Most cases of Tourette’s in older individuals are mild and almost unnoticeable
 
Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases.  Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face. 
 

Can Tourette’s syndrome be treated?

In many cases, Tourette’s syndrome presents as a benign condition and doesn’t require any treatment at all.There is no cure for Tourette’s syndrome. Treatment protocol mainly includes medications that can bring down the severity of the involuntary motions and/or vocals.Neuroleptics (drugs that may be used to treat psychotic and non-psychotic disorders) are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide). 
 
Many neuroleptic side effects can be managed by initiating treatment slowly and reducing the dose when side effects occur. The most common side effects of neuroleptics include sedation, weight gain, and cognitive dulling.  Neurological side effects such as tremor, dystonic reactions (twisting movements or postures), parkinsonian-like symptoms, and other dyskinetic (involuntary) movements are less common and are readily managed with dose reduction.
 
Discontinuing neuroleptics after long-term use must be done slowly to avoid rebound increases in tics and withdrawal dyskinesias.