Tourette syndrome is a problem with the nervous system that causes people to make sudden movements or sounds, called tics that they can't really control on their own. For example, someone with Tourette's might blink or clear their throat over and over again. Moreover, some people may blurt out words they don't intend to say. Treatments can control tics to a certain degree, but some people don’t need any unless their symptoms really bother them. Around 100,000 Americans have full-blown Tourette syndrome, but more people have a milder form of the disease. It often starts in childhood, and more boys than girls get it. Symptoms often get better as children grow up. For some lucky people, they go away completely.
What are the Symptoms?
Tics — sudden, brief, intermittent movements or sounds — are the trademark sign of Tourette syndrome. They can vary from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and even quality of life.
Tics are classified as:
- Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
- Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.
Tics also can involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.
What causes Tourettes?
Although the cause of Tourettes is unknown, current research points to abnormalities in some brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of Tourettes, the cause of the disorder is likely to be equally complex.
How is Tourettes diagnosed?
Diagnosis that doctors make for Tourettes occur only after verifying that the patient has had both motor and vocal tics for at least 1 year. The existence of other neurological or psychiatric conditions can also help doctors make a diagnosis. Common tics are not often misdiagnosed by knowledgeable clinicians. However, atypical symptoms or atypical presentations (for example, onset of symptoms in adulthood) may require specific specialty expertise for diagnosis. In fact, there are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging (MRI) or computerized tomography (CT), electroencephalogram (EEG) studies, or some blood tests may be used to rule out other conditions that might be confused with TS when the history or clinical examination is atypical.
It is not uncommon for patients to obtain a formal diagnosis of TS only after symptoms have been present for some time. There are many reasons for this.For families and physicians unfamiliar with TS, mild and even moderate tic symptoms may be considered inconsequential, part of a developmental phase, or perhaps the result of another condition. For example, parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies. Many patients are self-diagnosed after they, their parents, other relatives, or friends read or hear about TS from others.
Treatment
Unfortunately, there's no cure for Tourette syndrome. Treatment is aimed at controlling tics that interfere with everyday activities and functioning. When tics aren't that serious, treatment might not be necessary. Because tic symptoms often do not cause impairment, the majority of people with TS require no medication for tic suppression. However, effective medications are available for those whose symptoms are very serious and unbearable. Neuroleptics (drugs that may be used to treat psychotic and non-psychotic disorders) are the most commonly useful medications for tic suppression; a number are available but some are more effective than others.
Most of the times, tics are mild and don't need to be treated. If they become a problem, your doctor may prescribe medicine to help them. It can take a while to find the right dose that helps control tics but avoids side effects, so try to be patient as you and your doctor work through it.
