Tourette Syndrome

Tourette syndrome

Description and Incidence

Gilles de la Tourette Syndrome is one of a number of tic disorders usually first diagnosed in infancy, childhood, or adolescence. The Tic Disorders can be distinguished from one another based on duration and variety of tics and the age at onset. Tourette's Disorder has duration of more than 12 months.

The estimated incidence of Tourette's ranges widely but is probably four to five individuals per 10,000. It occurs two to three times more frequently in males. Undoubtedly, there are numbers of other students with symptoms who have not been diagnosed. When diagnosed and treated early, many of the associated learning, emotional, and social disabilities it produces can be lessened or dealt with more effectively. The goal of any program for a person with Tourette Syndrome is to assist the person in learning and interacting productively in school and society.

Toruette Syndrome is a multiple tic disorder, with motor and vocal tics present, but not necessarily concurrently, which begins in childhood and is a lifelong condition that seems to change in its manifestations and intensity.

The cause of Tourette Syndrome is unknown. The basic defect is thought to be a biochemical abnormality in the ganglia of the brain.

Diagnosis

1. Age of onset before the age of 18, usually between 6-7 years of age

2. Rapid, recurrent, repetitive, purposeless, and involuntary motor movements affecting multiple groups of muscles.

3. Multiple vocal tics (grunts, barks, moans, shouting of socially inappropriate words or phrases, etc.)

4. Ability to suppress movements and sounds voluntarily for minutes to hours.

5. Variations in the intensity of symptoms over weeks or months.

6. A duration of symptoms for more than one year with no tic-free period of more than three months.

Symptoms

Tourette Syndrome begins in childhood, usually with a single tic involving the head. The tic may be eye blinks, facial grimaces, or head tics. Tics can spread to the trunk and legs and may result in major motor activities such as hopping, jumping, and kicking. Vocal tics may occasionally be the presenting symptom. Not all patients have vocal and motor tics present at the same time though both will occur at the same time during the course of the disorder. A small group of patients develop coprolalia (involuntary cursing) and others develop echolalia (repetition of another's words or phrases), palilalia (repetition of one's own words or phrases with increasing rapidity), echokinesis or echopraxia (imitation of the movements of others), and coprapraxia (impulsive obscene gestures). Other symptoms are touching, repetitive thoughts, and obsessive-compulsive behavior.

Treatment

There is a wide range of medications available for the treatment of the Tourette Syndrome. Drugs such as pimozide (Orap) and clonidine (Catapres) are used to control tics. Antidepressants and stimulants are prescribed