What are the Symptoms of Tourette Syndrome?

Motor and vocal tics of persons with TS can either be mild or severe, simple or complex. Tics are said to be simple if they are sudden or fast and repetitive and usually involve a limited number of muscle groups. Simple tics include eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throatclearing, sniffing, or grunting sounds. Complex tics, on the other hand, involve multiple muscle groups and tend to produce a pattern or steps of movements. Complex motor tics appear slower and more deliberate than simple motor tics. Complex vocal tics involve meaningful words, phrases or sentences. Both types of motor and vocal tics cause extreme emotional pain and even physical pain as in the case of motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Some tics are even described to have a warning sign as evidenced by a certain urge or sensation in the affected muscle group that is very uncomfortable to the person. That's why persons who have TS may often describe a certain way or number of times to complete a tic just to relieve the sensation. Just like an itch waiting to be scratched. Most of the time the tics can be controllable for several hours but once it is expressed the tics are usually stronger and may last longer. The strong occurence of tics can also be observed when the person is under stress but are not much of a problem during rest. Tics occur in cycles and may often get better or worse. Others develop new tics as they grow older. Depending on the kind of tic or tics, these symptoms may be very debilitating to the person. These symptoms are only part of the whole disorder of Tourette Syndrome. There are also certain behavioral abnormalities associated with TS. Some person may also have trouble paying attention and may be grumpy at times or even have bouts of depression. One feature of behavioral abnormality is when they think of the same thoughts over and over again which is what they call a mental tic or commonly known as an obsession. Some of these are attention deficit hyperactivity disorder (ADHD) and disruptive behaviors, including conduct disorder and oppositional defiant disorder, with aggressive, destructive, antisocial, or negativistic behavior. Academic disorders, learning disorders, and sleep abnormalities (such as sleepwalking and nightmares) are also seen in TS patients. SIMPLE MOTOR TICS blinking eyes jerking head shrugging shoulders facial grimacing rolling eyes up squinting smacking lips jaw snapping COMPLEX MOTOR TICS jumping touching other people or things smelling twirling about thrusting of arms, groin, or torso pinching SIMPLE VOCAL TICS throat clearing yelping sniffing tongue clicking grunting coughing spitting humming whistling COMPLEX VOCAL TICS uttering words or phrases out of context repeating words or sounds stuttering repeating others' words (echolalia) repeating one's own last word or sound (palilalia)

self-injurious actions including hitting or biting oneself (rare)

talking to oneself muttering vocalizing socially unacceptable words (a rare tic called coprolalia)

What are the causes of Tourette Syndrome? The development of Tourette syndrome has been connected to parts of the brain known as the basal ganglia which is responsible for human activities such as regulation of movements, concentration, paying attention, and decision-making. Research has also shown that in TS there is a malfunction in the brain's production or use of important substances called neurotransmitters. Neurotransmitters are chemicals that control the signals that are sent along the nerve cells. Dopamine and serotonin are kinds of neurotransmitters which have been implicated in TS; noradrenaline is thought to be the most important stimulant. There are available medications that mimic noradrenaline that may cause tics in susceptible patients. TS has also been known to have a genetic component. If one parent has TS, each child has a 50% chance of getting the abnormal gene. Seven of every 10 girls who inherit the gene, and nearly all boys who inherit it, will develop symptoms of TS. Overall, about one in every 2,500 persons has full-blown TS. Three times as many will have some features, usually chronic motor tics or obsessive thoughts. Patients with TS are more likely to have trouble controlling their impulses which can lead to the development of dyslexia or other learning problems, and to talk in their sleep or wake frequently. Compulsive behavior, such as constantly washing the hands or repeatedly checking that a door is locked, is a common feature of TS. Compulsions are seen in 3090% of all TS patients. Recent research findings suggest that Tourette syndrome may also be related to an autoimmune response. A subset of TS patients have symptoms triggered by infection with Group A beta-hemolytic streptococci. In addition, blood serum antibodies against human basal ganglia have been found in patients with TS.

SUMMARY: imbalance in the brain's production or use of important substances called neurotransmitters--serotonin and dopamine malfunction of the basal ganglia which is responsible for regulating movements, concentration, paying attention, and decision- making genetic component 1. ONE PARENT HAS TS= each child has 50% chance of getting the abnormal gene 2. FEMALE CHILD= 7 out of 10 will inherit the gene hence will develop symptoms of TS 3. MALE CHILD = all boys will inherit hence all will develop symptoms of TS

Treatment/ Management The primary focus of treatment is to identify what symptoms are present and if any of the symptoms require therapy because the diagnosis alone is not enough to initiate a pharmacological treatment. Useful approaches for mild tics include: alpha-2 adrenergic agonists (e.g. clonidine, or guanfacine (US)); mild blockers of dopamine-2-receptors. Moderate to severe tics are treated by means of antipsychotic agents that are potent

blockers of dopamine-2 receptors (e.g. pimozide, or risperidone). The dosage of all drugs must be individually titrated in children; in all patients, it is advisable to start at a low dose. Of course, prior to the use of these medications, it is always necessary to look at the contraindications to these medications to avoid worsening the symptoms or even the disorder per se. Furthermore, the side effects should always be weighed against the severity of the symptoms. When it comes to diet and lifestyle, there is no particular dietary modifications recommended. It is always proven that tics become strong when the individual is under a stressful situation. Therefore, it is imperative for the individual to develop his or her own strategies to avoid the stressors. The individual can also ask the help of other professionals to aid him in other strategies available as treatments--counselors and psychologists, behavioral therapists and others. SUMMARY: Pharmacology: The use of medicines to lessen or control the occurrence of symptoms Behavioral Modifications: e.g. habit reversal, exposure response prevention techniques Alternative Strategies: Relaxation techniques, counseling ( development of support groups, individual counseling, group counseling, music therapy, art therapy, etc.), psychosocial therapy

Symptoms of Tourette Syndrome

Click to Check y y y y y y Repeated involuntary movements Uncontrollable vocal sounds Tics Facial tics Eye blinking more symptoms...

See full list of 47 symptoms of Tourette Syndrome

Treatments for Tourette Syndrome

y y y y y y Watchful waiting - some cases are mild and are simply tolerated; some cases improve over time and remission can occur after adolescence. Neuroleptic drugs Sedatives Antihypertensive drugs Tranquillizers more treatments...

See full list of 10 treatments for Tourette Syndrome

Home Diagnostic Testing

Home medical testing related to Tourette Syndrome:

Nerve Neuropathy: Related Home Testing: o Home Diabetes Test Kits o Home Blood Glucose Testing Kits Brain & Neurological Disorders: Related Home Testing: more...

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Wrongly Diagnosed with Tourette Syndrome?

y y y y Misdiagnosis of Tourette Syndrome Failure to diagnose Tourette Syndrome Hidden causes of Tourette Syndrome (possibly wrongly diagnosed) Undiagnosed: Tourette Syndrome

Tourette Syndrome: Related Patient Stories

y y y y y y y y y y y y y y y loss of motor skills Impulse control disorder Help! Fidgity! cant focus!! tic!! ? if medicacion causing tourette tics Mystery Malady - wife Please help! No Gross Motor control. Can't walk or talk (have celiac disease) Need Real Expert on Chronic Motor Tic Disorder I have tics but I dont think its tourettes, please help. PART II: Need serious help, in tears & _ the end of my rope! stripped vocal chords , , - - ! , ... Allo d'une amateure de plein-air Psychological effects of DES (nlp) motor and ocd