Tourette’s syndrome (TS) is a neurological disorder that causes people to make sudden uncontrollable movements or noises (tics.) TS patients can hold tics in for a brief period of time, but, like a sneeze or cough, they eventually must be let out. Mild tics can be distracting or embarrassing, but severe TS is nearly debilitating as sufferers struggle to concentrate or complete a task.
Diagnostic Criteria
There are no tests to diagnose Tourette’s. It is diagnosed based on the history of the tics meeting a set of criteria. According to the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association;
- Tics must begin before the age of 18.
- Tics must occur several times a day every day or nearly every day.
- The tics must be present for at least one year. Though there will most likely be periods in which they subside or flare up, they must not subside for more than a three-month period.
- Both motor and vocal tics must be present.
What do the Tics Look Like?
Tics can vary widely from one individual to the next. Tics can take on the form of just about any motion imaginable.
Some of the first tics to emerge may include a shoulder shrug, grimace, sniff, or a slight jerking motion of the wrists (as if someone is shaking a little water off of their hands). These motions may not be dramatic or disturbing but when they are done repeatedly in exactly the same way and cannot be controlled, they may signal a mild case of Tourette’s Syndrome.
Those same tics may become more dramatic, or so frequent that they are hard not to notice. More severe tics can include head jerking and stiffening of arms and legs. People with TS may need to punch the air, tap on a table or on their legs in a certain pattern or hop in a certain pattern.
In rare cases, people with TS need to yell out a certain word which may always be the same, or may change with circumstances. Sometimes the person becomes uncontrollably fixated on the very thing they know they should not say, such as a profanity or socially inappropriate slur. In these cases, much like a cough, the word will eventually need to be released.
Associated Conditions
People with TS have the same intelligence ranges as people in the general population. Though many TS patients have no other conditions, there is a higher frequency of Obsessive Compulsive Disorder, AD, or ADHD associated with Tourette’s. There is also a higher incidence of behavior manifestations, or personality traits that exhibit mild elements of these disorders.
For instance, parents may report that their children with Tourette’s are easily irritated and inflexible and become vigilant about routine or have volatile tempers if interrupted, though these children may not meet the criteria for obsessive compulsive disorder.
What Causes Tourette's Syndrome?
The exact cause of Tourette’s Syndrome is not yet known. According to the Mayo Clinic, the most common theory holds that a combination of heredity and environment are contributing factors. Specific genes relating to Tourette’s have not been found but it occurs more frequently in families.
Some theories suggest that certain infections such as untreated streptococcus may trigger Tourette’s, though these theories are controversial.
While no one knows what causes it, environmental conditions can aggravate existing Tourette’s. Restrictive clothing can trigger tics in the area of the body being restricted. Stress and anxiety can trigger or increase tics. When a person with TS is calm, comfortable and focused the occurrence and severity of tics can be reduced.
Treatment
There is no cure, and treatment only focuses on alleviating the symptoms. Many people with TS manage their tics and learn to cope with them. For severe cases, western medicine relies on drug therapy, using medicines prescribed for hypertension, depression and ADHD with varying levels of success.
Accupuncture and eastern medicines report higher success rates at treating Tourette's, though the Western medical community has yet to embrace these methods.
According to National Institute of Neurological Disorders and Stroke, Tourettes generally becomes more severe during puberty and fades in late teens. In many cases the symptoms of Tourette’s can disappear or fade almost completely in adulthood. Only 10% of TS cases are progressive or disabling through adulthood.
Sources:
Tourette’s Syndrome Association
Kimbra Cutlip - Kimbra Cutlip is a feature writer whose work has appeared in numerous publications including the Washington Post, Environment magazine, ...
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