Tourette's Syndrome

Symptoms are the subjective evidence of disease or physical disturbance observed by the patient that indicates the presence of a disorder.

The general symptoms of Tourette Syndrome can be divided into motor, vocal, and behavioral manifestations. Though the behavioral manifestations are not essentially listed in the DSM as diagnostic criteria, there are those that believe behaviors like ADHD and OCD are common enough to be considered a co-morbid condition to Tourette Syndrome. The DSM does make note of this.

About 11-20% of persons coming to clinics have no other disorder, or could be referred to as "TS-Only." They tend not to have other problem behaviours. The others meet, on average, criteria for 2 additional disorders, most often ADHD and/or obsessive-compulsive disorder OCD.

Tourette Syndrome symptoms can be experienced as mild, moderate, or severe. The severity is measured by the symptoms’ frequency, complexity and the degree to which they cause impairment or disruption of the patient's ongoing activities and daily life.

Tourette Syndrome symptoms also have various other scales that symptoms can be rated by to help in the evaluation and effectiveness of clinical research. Some of these scales are:

Tourette Syndrome Global Scale (TSGS)

Clinical Global Impressions Scale (CGIS)

Yale Global Tic Severity Scale (YGTSS)

The Tourette Disorder Scale (TODS)

Yale Global Tic Severity Scale (YGTSS)

These developed scales for tic disorders that use objective criteria may evaluate severity for clinical clarification, however, what may be experienced by the patient may feel completely different. What may be experienced as mild to moderate Tourette Sympotms by one person may feel sever to another and vice versa.

There may be tremendous variability over short and long periods of time in symptomatology, frequency and severity. Tics typically occur in "bouts" with many tics over a short interval of time.

In addition to the moment-to-moment or short-term changes in symptom intensity, many patients have oscillations in severity over the course of weeks and months. The waxing and waning of severity may be triggered by changes in the patient's life; for example, around holidays, children may develop exacerbations that take weeks to subside. Other patients report that their symptoms show seasonal fluctuation. However, there are no rigorous data on whether life events, stresses or seasons do, in fact, influence the onset or offset of a period of exacerbation. Once a patient enters a phase of waxing symptomatology, a process seems to be triggered that will run its course for weeks or months.

In its most severe forms, patients may have uncountable motor and vocal tics during all their waking hours with outburst of full body movements, shouting or self-mutilation. At times the tics seem organized in orchestrated patterns that are characteristic of that individual. Despite this, many patients with severe tics manage to achieve adequate social adjustment in adult life, although usually with considerable emotional pain. More than the severity of motor and vocal tics, the factors that appear to be of importance with regard to social adaptation include the seriousness of attention problems, obsessive-compulsive symptoms, the degree of family acceptance and support, intelligence and ego strength.

Understanding the symptoms is what will help clinicians and patients reach goals for the treatment of Tourette Syndrome. The goal of treatment should not be to completely eliminate all the tics and symptoms, but to relieve tic-related discomfort or embarrassment and to achieve a control of the Tourette symptoms that allows the patient to function as normally as possible. Read more about Tourette Syndrome treatment here...

Now lets look at the official symptoms of Tourette Syndrome and some of the unofficial related Tourette symptoms. Some of the symptoms experienced by patients, official or not, don’t always simply fall into the tics category, or comorbid and associated conditions. Nonetheless, these symptoms can sometimes cross over into various other neurological disorders and conditions and are worth discussion among “Touretters”.

Official Symptoms of Tourette Syndrome

A simple diagnosis of Tourette Syndrome would only require you to have these basic qualifications as symptoms of Tourette Syndrome: involuntary body movements and vocal outbursts (Tics) for at least 12 months. That's it! If you have Tourette Syndrome Only aka "TS-Only" officially all you will have are tics. You can view the complete official diagnostic criteria for Tourette's Disorder (DSM) here.

Common Official Tourette Syndrome Symptoms

• Tics (list) are rapid movements or sounds that are repeated over and over for no reason. Tics are brief, intermittent, repetitive, nonrhythmic, unpredictable, purposeless, stereotyped movements (motor tics) or sounds (phonic or vocal tics). Although Tourette Syndorme tics are often described as "rapid" or "sudden," not all are; some tics are "held" or "tonic" movements involving freezing in a position for a few seconds. A person with a tic can't control the movement or sounds. Read more about Tourette Syndrome Tics...

Rare Official Tourette Syndrome Symptoms

• Coprolalia (complex vocal tic - outburst of obscenities and curse words) and other coprophenomena.

Self-destructive Behaviors in Tourette Syndrome Symptoms

• Head banging (motor tic)

• Eye poking (motor tic)

• Lip biting (motor tic)

Commonly Associated Conditions in Tourette Syndrome

The most frequent associated conditions are:

• Obsessions and compulsions i.e. Obsessive-compulsive disorder (OCD)

• Inattention i.e. Attention-deficit-hyperactivity disorder (ADHD)

• Learning disabilities

• Behavioral problems