Tourette Syndrome (TS) is a neurological condition characterized by stereotyped, repetitive, involuntary movements and vocalizations called tics. Average onset of symptoms is between 3 and 9 years.It runs in families and is sometimes associated with OCD (Obsessive Complusive Disorder) and ADHD (Attention Deficit Hyperactive Disorder)

Features

  1. Tics
    1. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Examples –
      1. Eye blinking and other eye movements
      2. Facial grimaces
      3. Shoulder shrugging
      4. Head or shoulder jerking
      5. Vocalizations( vocal tics) – repetitive throat clearing, sniffing, grunting sounds or barking
    2. Complex motor tics are distinct coordinated patterns of movements involving several muscle groups. These may look un purposeful Examples
      1. Facial grimacing combined with a head twist and shoulder shrug
      2. Sniffing and touching objects, hopping, jumping, bending or twisting
    3. Disabling tics include motor movements that result in self harm such as punching oneself in the face or vocal tics including coprolalia (speaking socially inappropriate words and swearing) or echolalia     ( repeating words or phrases of others)
    4. 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.
  2. Children with Tourette’s syndrome may also have other behavioural problems, such as flying into a sudden rage, or behaving inappropriately or anti-socially with other children.

Cause

The cause of Tourette’s syndrome is unknown. It is thought to be linked to problems with a part of the brain known as the basal ganglia, which helps regulate body movements.

In people with Tourette’s syndrome, the basal ganglia ‘misfire’, resulting in the characteristic tics.

Intervention

Psychological intervention in the form of behavioural therapy are a must for children with behavioural problems. Speech language therapy and Ocuupational therapy might be needed for children with ADHD. When the tics are more frequent or severe, a number of medications can help to improve them, such as alpha2-adrenergic agonists, muscle relaxants and dopamine antagonists.

Surgery may be recommended in very severe cases that do not respond to treatment. However, surgery for Tourette’s syndrome is very rare.