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While the exact cause of Tourette’s syndrome is unknown, genetic and environmental factors likely play a key role in causing damage to nerve cells
Tourette syndrome is a neurological disorder characterized by sudden, repetitive, and uncontrolled movements or sounds called tics.
While the exact cause of Tourette syndrome is unknown, some researchers speculate that problems in the basal ganglia—the part of the brain responsible for controlling movement—can affect the nerve cells that carry messages throughout the brain network. Genetic and environmental factors likely play a key role in causing this damage.
Mutations in the SLITRK1 gene may also play a role in the production of a protein involved in the growth and development of the nerve cells, which can lead to the condition.
According to the Tourette Association of America, 1 out of every 160 children in the United States is affected by Tourette syndrome. The disease typically begins in childhood (ages 5-10), and boys are about 3 times more likely to be affected than girls.
What are the symptoms of Tourette syndrome?
Tourette syndrome symptoms may be mild and not very noticeable. Others may be more obvious. The main symptom of the disease is tics:
- Motor tics
- Blinking
- Eye rolling
- Facial grimacing
- Mouth twitching
- Sudden arm or head jerking
- Shoulder shrugging
- Jumping
- Bending or twisting
- Vocal tics
Tics can be suppressed for a short period of time, but they cannot be stopped completely. They can be triggered factors such as:
What are tics?
Tics are sudden, rapid, repetitive, and involuntary movements or sounds. Tics vary in type, frequency, location, and severity. Severe tics can significantly hamper communication, routine activities, and quality of life.
Some tics are preceded by an urge or unusual sensation in the affected muscle group called premonitory urge:
- Burning in the eyes that relieves after blinking
- Dry and scratchy throat that relieves only after clearing or grunting
- Increased muscle tension that is relieved by twisting
- Itching sensation in the limb alleviated by stretching
Tics are classified into two types:
- Simple tics:
- Sudden and repetitive tics that involve 1-2 parts of the body
- May precede complex tics
- Examples include squinting the eyes or sniffing
- Complex tics:
- Involves many parts of the body
- Coordinated patterns of movements
- Examples include head movement along with jerking of the arm, jumping, and kicking
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The abbreviated term ADHD denotes the condition commonly known as:
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How is Tourette syndrome diagnosed?
If your child has symptoms of Tourette syndrome, consult a neurologist. Since there are no particular tests that can diagnose the condition, your doctor will focus on asking questions based on current symptoms, duration, and medical and family history.
A diagnosis of Tourette syndrome can be made if the person has multiple motor tics and at least one vocal tic for at least a year.
Tests that the neurologist may recommend include:
- Electroencephalogram: Studies the electrical activity of the brain to rule out other medical conditions
- MRI scan: Imaging study that can diagnose problems in the brain and rule out other conditions
- CT scan: Imaging study that uses X-rays that produce images of the brain
Can Tourette syndrome be cured?
In most cases, symptoms are mild, improve as the child grows, and may go away completely when the child reaches their 20s. In some cases, however, symptoms can worsen during adulthood, and a few will have tics for the rest of their lives.
There is no cure for Tourette syndrome, but treatment can help manage symptoms.
- Medications:
- Dopamine blockers: Haloperidol, fluphenazine and pimozide
- Alpha-adrenergic agonists: Clonidine and guanfacine
- Antidepressants: Clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline
- Stimulants: Methylphenidate and dextroamphetamine
- Behavior therapy:
- Habit-reversal training: Helps the patient recognize, respond to, and control tics
- Exposure with response prevention: A training method to control the urge to perform the tic
- Psychotherapy: A psychologist or counselor can help the patient deal with the associated symptoms of ADHD, depression, anxiety, and obsessive-compulsive disorder.