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Writer's pictureGitesh Chawla

Understanding Tourette Syndrome: Causes, Symptoms, and Treatment

What is Tourette Syndrome? 

Tourette syndrome is a neuropsychiatric disorder that commences in childhood, most often before the age of 18 years and is frequent onset is between 5 and 10 years. It is a clinical disorder which is manifested by hyperkinetic, rapid, irregular movements and sounds called tics. These tics can thus be described as ranging from mild to severe and also in the variability, where they might increase in severity or decrease in frequency at some point. Tourette Syndrome is usually referred to as Tourette, after the French scientist Dr. Georges Gilles de la Tourette who first wrote about it in 1885. 


Causes of Tourette Syndrome 

Although, scientists are yet to ascertain any definite cause of Tourette Syndrome, it can be concluded that the syndrome has multifactorial causes including genetic and environmental factors. Researchers have found that failures in the basal ganglia, also, the frontal lobes and the cortex may lead to tics. These areas of brain are related to the motor control and behavioral management and this correlates well with the symptoms seen in the people with TS. 


Tourette Syndrome is also involving genetic factors. Symptoms are likely inherited, which means that this disease tends to have an hereditary nature. Nonetheless, the specific genes that cause TS have not been ascertained with certainty In any case, the genes are limited to chromosomes 2, 8 and 14. Current thinking is that different genes may be involved in the disorder and each may increase the risk of tic formation. 


The environmental factors which include complications before birth, stress, and infections, may also play a role in the development and the severity of the TS. These factors are however viewed as the secondary factors that precipitate an already existent genetic vulnerability. 


Symptoms of Tourette Syndrome 

The common manifestations of TS include Motor and vocal tics. These tics are typically classified into two categories:


Transcranial magnetic stimulation is classified as simple tics, which are acute involuntary movements including vocal or motor stereotyped behaviours lasting for less than a minute and including a minimal number of muscles. Examples are; rolling the eyes, shrugging the shoulder, clearing the throat, and making grunting sounds. 


Complex tics involve more than one muscle group; these are repeated movements of sounds in association with it. These may include the following; blinking of eyes, moving the head, repeating the words and phrases of others (echolalia), using of obscene words and phrases inappropriately (coprolalia). 


Tourettes tics can be changed in frequency, severity, and even the type of the tic. They get aggravated in conditions of stress or excitement or when one is too tired and tend to improve when one is in a relaxed mood or when working on a particular task intensely. It is important to understand that tics are not voluntary – on the contrary, some TS people may experience something called ‘premonitory urge,’ or the desire that occurs before the tic, which a subject is sometimes capable of restraining. 


TS’s impact on daily life may not differ substantially from other chronic diseases because people with TS are usually aware of their tics and try to suppress them.  


Tourette’s Syndrome: Possibilities of Treatment 

Currently, there is no known cure for Tourette Syndrome or the co-occurring conditions that are most often associated with it; however, there are several treatment methods that are available. The treatment process is largely personalised depending on how severe the tics are, whether the patient also has other disorders such as ADHD or OCD among others, or how much the tics interfere with one’s life. 


  • Behavioral Therapy: CBIT also known as Comprehensive Behavioural Intervention for Tics is a type of therapy that was found to be helpful in lessening of tics. CBIT helps a person to identify the desire to tic and then replace it with a response that is less attention grabbing or bothersome. 

  • Medications: Although tics themselves do not require treatment per se, if tics are very prominent or if they are impairing the patient’s daily life, drugs may be given. These can include anti psychotic medicines, Alpha-adrenergic agonist medicines or medicines that modulate neurotransmitters that are involved in regulation of tics. Bear in mind that medication is often thought to be the last resort because it has side effects to it.

  • Supportive Therapies: Students with TS may benefit from occupational and speech therapy as well as educational support if they face some problems at school or in the workplace. Self-help support groups and counseling may also be helpful in providing emotional support and methods of managing TS and its effects on the patient and the family. 

  • Deep Brain Stimulation (DBS): However, Deep Brain Stimulation (DBS) treatment is only used in the most severe forms of tics and where no other treatment methods have shown effectiveness. DBS is a method that uses electrodes that has to be placed in certain parts of the brain to treat abnormal electrical activity in the brain. This treatment is used only for severe Tourette Syndrome and is still considered rather experimental. 


Living with Tourette Syndrome

However, people who suffer from such a disorder as Tourette Syndrome should always be aware of the fact that patients usually have more talents and abilities compared to tics. Formost, many people with TS are intelligent and resourceful; they are endowed with high level of creativity. Proper assistance and medications must be given to the people suffering from this condition so that they are able to effectively and optimally engage in various activities and tasks and live a complete life. 


Efforts needed to educate the public about the condition are equally paramount as stigmatization has always followed the illness. TS victim awareness, awareness campaigns and public sensitisation could go a long way in ensuring that persons with TS could lead well-adjusted healthy lives both in their personal and professional lives.


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