Tourette syndrome is a neurological disorder that involves repetitive movements ore unwanted sounds (tics) that can’t be easily controlled. It is the most severe form of a tic disorder. Tic disorder is a sudden repetitive movement, gesture or utterance. Tics are usually brief and occur in bouts. It can be motor, vocal, simple or complex. Tourette’s syndrome is a hereditary disorder that begins in childhood. It is seen as multiple motor tics disorder and one or more vocal tics many times throughout the day for one year or more. The age at onset of the disorder can be early as age 2 years but occurs most commonly during childhood at about 6-7 years. Males are about three to four times more likely than females to develop Toured syndrome. The duration of the disorder may last throughout lifetime although there may be time when the symptoms will not be seen that last from weeks to years. Tourette’s syndrome does not affect psychologically as children who has the disorder can also do regular activities like schooling and excel.

SYMPTOMS

Tics is  the significant sign of Tourette syndrome. It can range from mild to severe. Severe symptoms might affect communication and activities of daily living and quality of life.

Tics could be motor or vocal, and the two come as simple or complex.

 Simple Motor tics are:

  • Eye blinking
  • Head jerking
  • Shoulder shrugging
  • Eye darting
  • Nose twitching
  • Mouth movements

Complex Motor Tics are:

  • Touching or smelling objects
  • Repeating observed movements
  • Stepping in a certain pattern
  • Obscene gesturing
  • Bending or twisting
  • Hopping

 Simple vocal tics are:

  • Coughing
  • Grunting
  • Throat clearing
  • Barking

 Complex vocal tics are:

  • Repeating one’s own word or phrases
  • Repeating others words or phrases
  • Using vulgar obscene or swear word.

The movements and vocalizations are experienced as compulsive and irresistible, but can be suppressed for varying lengths of time. Tics can also vary in type and severity; get worse with stress, anxiety or excitement.

Tics can be worse in the early teenage years and improve during the transition into adulthood.

CAUSES

The exact cause of Tourette’s syndrome isn’t known. It has been found that it could be due to genetic factor and environmental factors

Chemicals in the brain that transmits nerve impulses dopamine and serotonin can also play a role.

Risk Factors:

Family history: A family history of Tourette disorder or other tic disorder might increase the of developing Tourette disorder

Sex: Male children are ore likely to develop Tourette syndrome than females

TREATMENT.

The treatment is with supportive counseling, school modifications and individual therapy.

MEDICATION: various classes of medication can help control tics or reduce symptoms.

Antipsychotics: such as Fluphenazine, Risperidone, Haloperidol

Botulinum (Botox) injections: this will be given to the affected muscles to relieve simple motor or vocal tic

Stimulants: such as methylphenidate  can help increase attention and concentration

Central adrenergic inhibitors: Medications such as clonidine might help behavioral symptoms such as impulse control problems and rage attacks

Antidepressants: such as fluoxetine might help control symptoms of sadness, anxiety and Obsessive compulsive disorder

THERAPY

  • Behavior therapy.Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that’s incompatible with the tic.
  • In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety.
  • Deep brain stimulation (DBS).For severe tics that don’t respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement. However, this treatment is still in the early research stages and needs more research to determine if it’s a safe and effective treatment for Tourette syndrome.

SUPPORT THERAPY

Support therapy is essential in the care of a child with Tourette syndrome so as to cope well in the environment.

  • Be the child’s advocate. Help educate teachers, school bus drivers and others with whom your child interacts regularly. An educational setting that meets your child’s needs — such as tutoring, untimed testing to reduce stress, and smaller classes — can help.
  • Nurture your child’s self-esteem.Support your child’s personal interests and friendships — both can help build self-esteem.
  • Find a support group.To help you cope, seek out a local Tourette syndrome support group. If there aren’t any, consider starting one.