If you have Tourette syndrome, you make unusual movements or sounds, called tics. You have little or no control over them. Common tics are throat-clearing and blinking. You may repeat words, spin, or, rarely, blurt out swear words. 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 an inherited neurological disorder with onset in childhood, characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic; these tics characteristically wax and wane. Tourette’s is defined as part of a spectrum of tic disorders, which includes transient and chronic tics.
Transient tic disorder consists of multiple motor tics, phonic tics or both, with a duration of between four weeks and twelve months. Chronic tic disorder is either single or multiple, motor or phonic tics (but not both), which are present for more than a year. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation. Neuroleptics 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). Specific behavioral treatments that include awareness training and competing response training, such as voluntarily moving in response to a premonitory urge, have shown effectiveness in small controlled trials.
The exact cause of Tourette’s syndrome is unknown, but it appears to be linked to the gene or genes that control the chemicals that carry signals from one brain cell to another. About a third of people with the disorder have relatives with Tourette’s, while another third have family members with milder tic disorders.
Families of people with Tourette’s syndrome also tend to have a higher incidence of obsessive-compulsive behaviors and attention deficit-hyperactivity disorder.
Signs and Symptoms of Tourettes Syndrome
What are the symptoms?
Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. 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.
Treatment of Tourettes Syndrome
After much reading and research in the area of alternative treatment for such neurological disorders as Tourette Syndrome and ADHD, I have become convinced that alternative or holistic treatment does work in some cases.
Over the past 3 years I have received email from many parents claiming good to excellent results using natural remedies to treat their child’s Tourette Syndrome and I have read of similar accounts with ADD and ADHD.
Neuroleptics 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).
Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with TS.
Stimulants currently contraindicates the use of these drugs in children with tics/TS and those with a family history of tics.
Serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) have been proven effective in some patients.
Other medications may also be useful for reducing tic severity, but most have not been as extensively studied or shown to be as consistently useful as neuroleptics. Additional medications with demonstrated efficacy include alpha-adrenergic agonists such as clonidine and guanfacine.
Psychotherapy can’t make Tourette’s syndrome disappear, but it can help people learn to cope with the social and emotional problems that often result. Because tics tend to worsen with stress, relaxation techniques can help reduce the frequency and severity of Tourette’s symptoms.