Tourettes Syndrome - Causes, Symptoms & Treatment

Tourette's Syndrome is a fairly common childhood-onset condition that may be associated with features of many other conditions. People with Tourette syndrome usually first notice symptoms while they're kids or teens. TS affects people of all races and backgrounds, although more guys than girls have the condition. It affects between 100,000 to 200,000 people in the United States. The early symptoms of TS are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. People with Tourette's have normal life expectancy and intelligence. The severity of the tics decreases for most children as they pass through adolescence , and extreme Tourette's in adulthood is a rarity. Notable individuals with Tourette's are found in all walks of life. A person with Tourette's has about a 50% chance of passing the gene(s) to one of his or her children, but Tourette's is a condition of variable expression and incomplete penetrance It is more common in boys than girls. The main symptoms of TS are tics. Motor tics can be everything from eye blinking or grimacing to head jerking or foot stamping. Some examples of verbal tics are throat clearing, making clicking sounds, repeated sniffing, yelping, or shouting. In rare cases, people with TS might have a tic that makes them harm themselves, such as head banging. The tics usually start in childhood and may be worst in the early teens. Many people eventually outgrow them.

Tics are sudden, repetitive, stereotyped, nonrhythmic, involuntary movements (motor tics) and utterances (phonic tics) that involve discrete muscle groups. Tics are often worse with excitement or anxiety and better during calm, focused activities. Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Transient tic disorder consists of multiple motor tics, phonic tics or both, with a duration of between four weeks and twelve months. Chronic tic disorder is either single or multiple, motor or phonic tics (but not both), which are present for more than a year. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS 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. Neuroleptics are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide). Specific behavioral treatments that include awareness training and competing response training, such as voluntarily moving in response to a premonitory urge, have shown effectiveness in small controlled trials.

Causes of Tourettes Syndrome

Common Causes and Risk factors of Tourettes Syndrome

• Genetic factors.
• Serotonin.
• Environmental factors.
• Psychosocial factors.
• Brain chemical dopamine.

Signs and Symptoms of Tourettes Syndrome

Common Sign and Symptoms of Tourettes Syndrome

• Stress.
• Depression.
• Anxiety.
• Eye blinking or grimacing.
• Head banging.

Treatment of Tourettes Syndrome

Common Treatment of Tourettes Syndrome

• Neuroleptics are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide).
• Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with TS. 
• Stimulants currently contraindicates the use of these drugs in children with tics/TS and those with a family history of tics.
• Serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) have been proven effective in some patients. 
• Other medications may also be useful for reducing tic severity, but most have not been as extensively studied or shown to be as consistently useful as neuroleptics.  Additional medications with demonstrated efficacy include alpha-adrenergic agonists such as clonidine and guanfacine.
• Psychotherapy may also be helpful for Tourettes Syndrome. Psychotherapy can help the person with TS better cope with the disorder and deal with the secondary social and emotional problems that sometimes occur.
• Specific behavioral treatments that include awareness training and competing response training, such as voluntarily moving in response to a premonitory urge, have shown effectiveness in small controlled trials.