Tourette’s Syndrome

tourette

Definition: “This syndrome is the inherited disorder which results in both motor tics and phonic tics which are characterized by coordinated and repetitive movements and sounds.”

Children suffer from these tics at the age of 2- 3 years. There is a tendency in the tics that they tend to disappear with age and if they continue into adulthood, their frequency is low and decreased. Tourette Syndrome is actually a spectrum of tics disorders including all the tics along with transient or chronic tics. Prognosis of this disease is good. A child or person can spend his normal life with this syndrome as this is not a life threatening condition.

Sign and Symptoms

Waxing and waning type of tics are seen here. A child may present with repetitive blinking of eyes, twitching of eyes, coughing, jerking movement of neck, shrugging of shoulder, unusual sound from the nose or throat, and grunting sounds. In complex types of tics a person may harm his self, he repeats his own same words many times and this condition is called palilalia.  In other condition called Echolalia a person repeats others’ words. There may seem an urge to do these tics as well. These tics are non rhythmic and temporarily. They increase as a result of certain stimuli like emotional, physical or mental such as anxiety, excitement or fear.

Etiological Factors

Although the exact cause is unknown but it is seen that the children born to mother who smoked during her pregnancy or taken alcohol or undergone any stress or experienced extreme nausea and vomiting during first three months of the pregnancy suffer from this syndrome. It may also arise when during intra uterine life, a fetus does not get enough blood and oxygen supply. This disease may be seen in low birth babies as well. So this disease is mixture of both genetic and environmental factors. This disease can be transmitted by an affected parent to his child since it is genetically linked.

Diagnosis

It is done on the basis of complete history, family history and physical examination. Certain tests are done to rule out other similar kind of disorders. These include autisms, simple tics, hypothyroidism, or other brain disorders along with certain movement disorders. MRI or CT scan is done in this case to rule our brain changes or pathology.

Treatment*

It consists of not only pharmacological intervention but psycho behavioral therapy is also necessary for this syndrome. In case of a child, education is necessary to make him realize about these tics. These are called habit reverse trainings. For both adults and children certain therapies have been proved beneficial. They create awareness in them and educate them how to cope up with this problem without getting embarrassment. In case a person is depressed  or in any other state of mind illness like anxiety, etc and feel these tics, his depression has to removed by giving antidepressants e.g.; fluoxetine, fluxoxamine or sertraline. These are serotonin reuptake inhibitors. Some neuroleptics have been found beneficial in patients with this syndrome such as pimozide, haloperidol or resperidone are affective drugs for this Tourette’s syndrome.

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