Tourette Syndrome

Tourette Syndrome

Description

Tourette syndrome (also called Tourette's syndrome, Tourette's disorder, Gilles de la Tourette syndrome, GTS or, more commonly, simply Tourette's or TS) is a neurological disorder with onset in childhood, characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic and has lasted for at least one year (Journal of Child Neurology; Aug2006, Vol. 21 Issue 8, p630-641, 12p). Tourette's was once considered a rare and bizarre syndrome, most often associated with the exclamation of obscene words or socially inappropriate and derogatory remarks known as coprolalia; which is a symptom in only about 10% to 15% of people with Tourette’s. Tourette Syndrome acquired its name from a 19th century neurologist, Georges Albert Ð"‰douard Brutus Gilles de la Tourette (1859вЂ"1904), who was a pupil of Charcot who published an account of nine patients with Tourette's in 1885. Between 1 and 11 children per 1,000 have Tourette's; as many as one in a hundred people may have tic disorders, with the more common tics of eye blinking, coughing, throat clearing, sniffing, and facial movements. People with Tourette's have normal life expectancy and intelligence. The severity of the tics decreases for most children as they pass through adolescence, and extreme Tourette's in adulthood is a rarity (Brown University Child & Adolescent Behavior Letter; Jul2001, Vol. 17 Issue 7, p1, 3p). Notable individuals with Tourette syndrome are found in all walks of life, including musicians, athletes and authors. The best-known example of a person who may have used obsessiveвЂ"compulsive traits to advantage is Dr Samuel Johnson, the 18th-century English man of letters, who had Tourette syndrome as clearly evidenced by the writings of James Boswell.[77] Johnson wrote A Dictionary of the English Language in 1747, and was a prolific writer, poet, and critic. The entertainment industry often depicts those with Tourette syndrome as social misfits whose only tic is coprolalia, which has furthered stigmatization and the public's misunderstanding of those with Tourette's (http://www.tourettes-disorder.com/history.html).

Diagnosis

Tourette’s can be diagnosed if an individual exhibits multiple motor tics and at least one vocal tic without a tic-free period of longer than three months, if the tics started before the age of 18 years, and if the tics are not due to substance use or a general medical condition (American Psychiatric Association, 2000). Motor tics typically begin between the ages of 3 and 8 years old, with periods of intense eye blinking or other facial tics. Vocal tics, such as repetitive bouts or sniffing or throat clearing, can begin as early as 3 years as well, but they often follow the onset of motor tics by several years (Human Psychopharmacology: Clinical & Experimental; Oct2006, Vol. 21 Issue 7, p447-453, 7p, 1 chart). Approximately three to four boys to one girl are diagnosed. The peak time of onset is 4 to 11 years of age with 7 as the average age of diagnosis. Tic symptoms may just be the tip of the iceberg. Approximately 50 to 60 percent of the Tourette population have co-morbid disorders and psychopathology including attention deficit hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD). The ADHD and anxiety often precede the tics, which at one time led to the idea that stimulant medication caused tics. Several studies have shown that not to be true; the tics occur and wax and wane regardless of stimulant use (Brown University Child & Adolescent Behavior Letter; Jul2001, Vol. 17 Issue 7, p1, 3p).

Treatment

The important thing to remember when treating Tourette’s is treatment is only necessary when it interferes with life. It’s also important to sort out whether the tic or tics are interfering with the child’s