Tourette’s Syndrome
Information about genetics
· Tourette’s is a genetic neurological disorder that causes verbal and motor tics.
· It is estimated that 0.3% to 0.8% of the world’s population has Tourette’s.
· As with many other neurological disorders, males have Tourette’s more frequently than females. It is suggested that this is because females have a larger basal ganglion.
· Twin studies show that although Tourette’s is an inherited disorder, there is a lot of variability in its expression based on environmental factors.
· Studies suggest that mutations in many different genes combine to cause Tourette’s Syndrome. This makes it a genetically complex multigene disorder.
More about genes
· TS is neither a dominant nor recessive disorder.
- A carrier has a 50% chance of passing genes associated with
TS to his/her children, but TS symptoms are not always expressed.
· It may show up as a milder tic disorder, or as Obsessive Compulsive Disorder or Attention Deficit Disorder with or without the association of tics.
· Pedigree analysis is not applicable to TS because the disorder is passed through many different genes on different chromosomes.
Symptoms/Effects
· Tics- Sudden brief, irregular movements or sounds that range from simple to complex
· Premonitory urge - An uncomfortable bodily sensation (itch, tingle or tension) that is relieved by expressing a tic.
Simple Tics
Sudden, brief, and repetitive. Involve few muscle groups.
Complex Tics
Distinct, coordinated patterns of movements. Involve many muscle groups.
Motor Tics
- Eye blinking
- Head jerking
- Shoulder shrugging
- Finger flexing
Vocal Tics
- Yelling
- Throat Clearing
- Sniffing/snorting
- Barking
- Grunting sounds
Motor Tics
- Smelling or touching objects
- Flapping the arms
- Hopping
- Touching the nose
Vocal Tics
- Using different tones of voice
- Coprolalia
- Echolalia
- Palallia
-Coprolalia (the involuntary and repetitive use of obscene language, as a symptom of mental illness or organic brain disease)
-Echolalia (meaningless repetition of another person's spoken words)
-Palallia (a language disorder characterized by the involuntary repetition of syllables, words, or phrases)
Symptoms/Effects
· Severe symptoms may affect a person with Tourette’s by interfering with communication, quality of life, and daily functioning.
· Tics are often worse with anxiety or excitement, and better during calm and focused activities.
· With extreme effort, some people can temporarily hold their tics back until they find a less disruptive location to express them, but this often causes tension to the point where they feel like the tics must be expressed (against their will).
· Tourette’s is often linked with ADD and OCD
Diagnosis
· There are no blood, laboratory, or imaging tests available to diagnose Tourette’s.
· Both motor and vocal tics must be present, but not necessarily at the same time.
· Tics must occur several times a day every day for at least a year.
· Tics cannot be caused by medications, other substances, or another medical condition.
· Often, patients receive a formal diagnosis long after the tics are present.
· Many people with Tourette’s are self-diagnosed after they, their parents, other relatives or friends hear about Tourette’s from others.
Prognosis
· There is no cure for Tourette’s, but the condition often improves in the late teens or early 20’s.
· It is a lifelong and chronic condition, but is not degenerative.
- People with Tourette’s have a normal life expectancy.
· Tourette’s Syndrome does not affect intelligence.
· Neurobehavioral disorders that are associated with Tourette's such as ADD, ADHD, OCD, depression, generalized anxiety, panic attacks, and mood swings can persist in adult life even though the severity of tics may decrease.
Treatment
· Medications
- may be taken to minimize the impairment caused by Tourette’s
· Behavioral treatments
- Awareness training and competing response training can be used to reduce tics.
· Supportive therapy
- Although this hasn’t been shown to reduce tics, can help a person with Tourette’s better cope with the disorder and the social and emotional problems that may occur because of it
