Tourette Syndrome (TS) is a neurological disorder that affects the brain and nervous system.
What is Tourette Syndrome?
It’s named after a French neurologist, Dr. Georges Gilles de la Tourette, who was the first to describe the condition in 1885. In the UK, it is estimated that over 300,000 adults and children have TS. It is more common in boys than girls.
Vocal and motor tics, namely involuntary sounds and movements that are difficult or impossible to control, are the main manifestations of TS. Tics can vary from a barely visible/audible movement and/or sound to a complex series of movements or phrases. It is fairly common for people with Tourette’s to also have symptoms of other conditions such as obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), sleep disorders, mood disorders and anger-management problems.
Genetic studies, neuroimaging investigations and clinical trials are being conducted in order to gain a deeper understanding of TS, improve diagnosis and treatment, and identify ways to better the lives of people living with the condition. The cause of Tourette’s isn’t known, but current research indicates that a part of the brain called the basal ganglia and a dysfunction of the neurotransmitters (chemical messengers in the brain) is involved. Studies conducted with twins and family members have presented strong evidence to suggest that it’s an inherited condition. Environmental factors combined with genes may also play a role.
TS is a lifelong condition. Symptoms tend to begin in early childhood. The intensity and frequency of tics can change over a person’s lifetime, and may be more prominent in mid/late childhood before improving in the late teens and adulthood. Tics can become more severe during periods of stress, anxiety, tiredness, excitement or illness.
As well as facial tics (e.g. eye blinking, lip smacking, grimacing), vocal tics (e.g. throat clearing, grunting, shouting) and/or motor tics (e.g. head jerking, foot stamping, neck stretching) someone with TS may have organisational difficulties, suffer from low self-esteem and moodiness and have compulsions or obsessions. Some people may show other fairly uncommon symptoms which include repeating what others say (echolalia), imitating other people’s actions (echopraxia), shouting out obscenities (coprolalia), repeating obscene gestures (copropraxia) or being unable to carry out an action (apraxia).
Diagnosis and treatment
TS is diagnosed by observing and evaluating symptoms. There are no blood, laboratory or imaging tests required for diagnosis, although one or more of these tests may be carried out in order to rule out other causes of tics. Motor and vocal tics have to be present for some time, at least a year, before Tourette Syndrome is diagnosed. Treatment may not be necessary if the tics are not severe. However, if the tics are interfering with everyday activities and functioning, medication may be prescribed to control them.
Behavioural therapy such as habit reversal training can help to reduce tics. Moreover, supportive therapy can help children and their families to better cope with the condition and deal with the social and emotional problems that sometimes accompany it. Identifying and treating these problems can make a significant difference to a child’s life.