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Tourette Syndrome: Causes, Symptoms, Diagnosis And Treatment

Tourette syndrome, also called Tourette's syndrome (TS), is a neurological disorder which causes people to make sudden repetitive movements, twitches or sounds, which are called tics that they can't control. For example, someone suffering from Tourette syndrome might blink often or clear their throat every time or they may even blurt out words which they don't intend to say.

The onset of Tourette syndrome starts during childhood before the age of 18 and affects up to one per cent of the population [1], [2]. Boys are more likely to develop Tourette syndrome compared to girls [3].

In 1885, Tourette syndrome was named in the honour of Georges Gilles de la Tourette, a French neurologist, who first described the condition in nine patients who developed tics [4].

Causes Of Tourette Syndrome

Although the exact cause of Tourette syndrome is not known. Researchers believe that it is caused by genetic, environmental or developmental factors.

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Symptoms Of Tourette Syndrome

The most primary symptom of this disorder is tics, which usually begin when a child is 5 to 10 years of age according to the Centers for Disease Control and Prevention (CDC). Tics can range from mild to severe.

Tics can be classified as either simple or complex motor tics and simple or complex vocal tics [5].

Simple motor tics - These are sudden, brief, repetitive tics that involve a limited number of muscle groups. Examples of motor tics include eye blinking, shoulder shrugging, mouth movements and head jerking.

Complex motor tics - These are distinct, coordinated patterns of movements involving many muscle groups. Examples of complex motor tics are facial grimacing combined with head jerking and shoulder shrugging, sniffing or touching objects, twisting, bending, jumping or hopping.

Simple vocal tics - These are repetitive sounds that a person makes. These include throat clearing, sniffing, coughing, whistling, barking or grunting sounds.

Complex vocal tics - When a person repeats their own words and phrases, others' words and phrases or involuntarily repeating the movements of another person.

Depression, anxiety, cognitive dysfunction, obsessive compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD) have been reported in patients with Tourette syndrome.

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Risk Factors Of Tourette Syndrome

Family history - Most children inherit this disorder from their families [6].

Sex - Tourette syndrome is more common in boys [7].

When To See A Doctor

If you notice your child showing involuntary movements or sounds or showing an unusual behaviour which lasts for more than a week, it is recommended to consult a doctor.

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Diagnosis Of Tourette Syndrome

There is no specific test to diagnose TS. The doctor will observe the symptoms to diagnose TS.

The criteria used to diagnose TS are: [8]

• Multiple motor tics and one or more vocal tics have been present, although not necessarily at the same time.

• Tics begin before 18 years of age.

• Tics happen several times a day or at irregular times for more than a year.

• Tics are not caused by another medical condition or other substances.

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Treatment Of Tourette Syndrome

There is no cure for TS and children with mild tics don't require treatment. However, medications and behavioural therapy are recommended to help manage tics if they are severe.

Behavioural therapy - It is considered the first-line treatment option. If the child is experiencing impaired quality of life, behavioural therapy is recommended. Two types of behavioural therapies such as habit-reversal training (HRT) and behavioural intervention for tics (CBIT) are useful in managing tics.

Medications - Antipsychotic medications can help control tics and reduce its severity. However, they cause severe side effects like sedation, weight gain and acute dystonia [9].

Common FAQs

Q. Can Tourette syndrome ever go away?

A. Tourette syndrome usually begins during childhood, but the tics usually improve after several years. Most patients will have complete or nearly complete remission of TS after 21 years of age.

Q. Is Tourette syndrome considered a mental illness?

A. Tourette syndrome is a neurological disorder.

Q. How does Tourette's affect your life?

A. Tics can cause pain or injury, interfere with school, work or social life and stress.

Q. Does Tourette syndrome shorten your life?

A. Although, the disorder is generally lifelong, but people with TS have a normal life expectancy.

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