Tourette syndrome (TS) is a neurological disorder
characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of Tourette syndrome are almost always noticed first in childhood, with the average onset between the ages
of 7 and 10 years. Tourette syndrome occurs in people from all ethnic groups; males are
affected about three to four times more often than females. It is estimated that
200,000 Americans have the most severe form of Tourette syndrome, and as many as one in 100
exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement
occurring in the late teens and continuing into adulthood.
What are the symptoms of Tourette syndrome?
Tics are classified as either simple or complex.
Simple tics
Simple
motor tics are sudden, brief, repetitive movements that involve a limited number
of muscle groups. Some of the more common simple tics include eye blinking and
other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds.
Complex tics
Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating
the words or phrases of others). Some tics are preceded by an urge or sensation
in the affected muscle group, commonly called a premonitory urge.
Some with Tourette syndrome will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen
tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often
significantly diminished.
What is the course of Tourette syndrome?
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Genetic disease is a disorder or condition caused by abnormalities in a person's genome. Types of genetic inheritance include single inheritance (for example, cystic fibrosis, sickle cell anemia, Marfan syndrome, and hemochromatosis), multifactoral inheritance, chromosome abnormalities (for example, Turner syndrome, and Klinefelter syndrome), and mitochondrial inheritance (for example, epilepsy and dementia).
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
Asperger disorder is characterized as one of the autism spectrum disorders.
People with Asperger syndrome have normal to above-average intelligence but
typically have difficulties with social interactions and often have pervasive,
absorbing interests in special topics.
Abnormalities in the subtle use of language and interpretation of language
are common with Asperger syndrome, although language development (grammar,
syntax, etc.) is normal.
The degree of severity of symptoms can vary among affected individuals.
Anxiety and frustration may contribute to disruptive behaviors or
depression in people with Asperger syndrome.
Successful treatment generally involves one or multiple social, behavioral,
and/or educational interventions.
The personality and cognitive traits common to those with Asperger syndrome
are seen as beneficial by many, and many people ...
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