Tourette Syndrome: What is it, its symptoms, what causes it and how to cure it.
Tics are a common condition, especially in childhood.
Tics are a common condition, especially in childhood. Tourette syndrome can also be defined as a neurological disorder that causes tics in the person.
What is Tourette Syndrome?
Tourette syndrome is a disorder that affects the nervous system and causes involuntary sudden movements (tics) and sounds. Repeated blinking and shrugging shoulders are examples of these behaviors. People with Tourette syndrome may make strange or meaningful sounds without thinking.
Tics usually begin to appear between the ages of 2 and 15. The probability of having tics in boys is 3-4 times higher than in girls.
There is no treatment that will completely eliminate Tourette syndrome. The main purpose of treating the disease is to control the symptoms seen in the person. If symptoms are not severe, treatment may not be needed for most Tourette syndrome patients. Tics generally become less frequent and more controllable as a person gets older.
What are the Symptoms of Tourette Syndrome?
Sudden, short-term and intermittent movements called tics; It is the most obvious symptom of Tourette syndrome. Tics can be mild or severe. Severe tics may cause the patient to have communication problems in daily life and decrease the quality of life.
Tics are divided into two as simple and complex tics:
- Simple Tics: Sudden, short-term and repetitive tics that involve only certain muscle groups.
- Complex Tics: In complex tics, where movements are distinct and coordinated, many muscle groups are involved in the movement.
Tics can also be divided into different groups as movement (motor) and voice (vocal) tics. Motor tics usually begin to appear before vocal tics. However, of course, the onset, type and severity of tics may vary between individuals.
The most common motor tics in Tourette syndrome:
1- Simple motor tics:
- Blinking
- say hi
- Shrug
- moving eyes rapidly
- nose twitching
- mouth movements
2- Complex motor tics:
- Touching and smelling objects
- Repeating the movements seen
- Stepping into a certain pattern
- making obscene gestures
- spin around
- Jump
Common vocal tics in Tourette syndrome:
1- Simple vocal tics:
- Grumble
- Cough
- throat clearing
- Bark
2- Complex vocal tics
- Don’t repeat your own words
- Do not repeat words that someone says
- Do not say rude, abusive or obscene words
Tics; It may increase in situations such as stress, anxiety, fatigue and excitement. Tics can also occur during sleep. The tics seen in a person may change over time. While tics are more severe in early adolescence, they may ease in adulthood.
Before motor or vocal tics appear, a condition called anticipatory impulse occurs in the person. The anticipatory impulse creates an uncomfortable feeling in the person in the form of itching, tightness, or tingling. The formation of a tic allows this uncomfortable feeling to disappear. People with Tourette syndrome can temporarily suppress the tic movement by making a great effort.
What Causes Tourette Syndrome?
The mechanisms that cause Tourette syndrome have not yet been fully clarified. Experts think that both genetic and environmental factors may play a role in the development of the syndrome. Chemical molecules (neurotransmitters) such as dopamine and serotonin, which provide signal transmission in the brain, may also be involved in the development of Tourette syndrome.
Situations that pose a risk for Tourette syndrome are as follows:
- Family History: The risk of Tourette syndrome is increased in people with a family history of Tourette’s or other tic disorders.
- Gender: Men are more likely to have Tourette syndrome.
How to Diagnose Tourette Syndrome?
There is no specific diagnostic test for Tourette syndrome. To diagnose the syndrome, the person’s history and the signs and symptoms seen in the person are taken into account.
Various conditions present in the person may indicate Tourette syndrome:
- Having both motor and vocal tics (not necessarily at the same time)
- Tics that occur every day, several times a day, persist for more than 1 year
- Tics begin before age 18
- Absence of conditions such as drug or substance use or medical illness that may cause tics
- Changes in the location, frequency, type, complexity and severity of tics
Symptoms of Tourette syndrome may sometimes be similar to other conditions, which may lead to errors in diagnosis. For example, blinking behavior may occur due to some eye problems. It is necessary to pay attention to such situations when making a diagnosis.
Generally, the presence of both motor and vocal tics is decisive for the diagnosis of Tourette syndrome. Diagnostic methods such as blood tests and MRI imaging can also be used to investigate whether a person’s tics are due to other health conditions.
What are the symptoms that occur with Tourette Syndrome?
In people with Tourette syndrome, other neurobehavioral problems may accompany the syndrome. These problems can cause more problems than Tourette syndrome. While tics caused by Tourette syndrome decrease in adulthood, neurobehavioral problems may persist.
Conditions that frequently accompany Tourette syndrome can be summarized as follows:
- Attention Deficit Hyperactivity Disorder (ADHD): Includes problems with concentration, hyperactivity, and impulsivity.
- Obsessive Compulsive Disorder (OCD): It is characterized by obsessions and repetitive systematic movements that develop due to these obsessions. Examples of repetitive movements include washing hands, checking under the stove, and cleaning.
- Anxiety: It is a situation in which the feeling of fear, worry and anxiety is intensely experienced in the face of events.
- Learning Disabilities: In learning difficulties, problems independent of intelligence are seen in skills such as writing, reading and counting.
- Behavior Problems: Includes situations such as anger, aggression, and inappropriate behavior that make it difficult to adapt to social life.
- Sleep Related Problems: People may have problems falling asleep or sleeping soundly.
- Deficiency in Social Skills: It is the situation of having problems in establishing or maintaining social relationships.
How is Tourette Syndrome Treated?
The main purpose of Tourette syndrome treatment is to control tics and prevent them from hindering the person’s daily life. Both medication and various therapies can be used for treatment.
The drugs used in treatment are as follows:
- Drugs that Reduce or Block the Effect of Dopamine: Drugs containing active ingredients such as fluphenazine, haloperidol, risperidone, pimozide can control tics.
- Botulinum Injections: Injecting botulinum into the muscle used in the tic can help relax the muscle and thus alleviate the tic.
- ADHD Medications: Methylphenidate and dextroamphetamine increase attention and concentration.
- Central Adrenergic Inhibitors: Drugs containing clonidine and guanfacine contribute to reducing behavioral symptoms such as impulse control problems.
- Antidepressants: Fluoxetine; It can be used in Tourette syndrome patients who also suffer from anxiety and Obsessive Compulsive Disorder (OCD).
Therapeutic methods that can be preferred in the treatment of Tourette syndrome are as follows:
- Behavior Therapy: Cognitive behavioral therapies can help control tics. These therapies also teach the person to identify the anticipatory urge and replace the tic with a behavior to relieve the urge.
- Psychotherapy: Psychotherapy helps to cope with both the symptoms of Tourette syndrome and additional conditions such as OCD, anxiety and ADHD.
- Deep Brain Stimulation: Deep brain stimulation may be effective in severe tics that cannot be controlled with other treatment methods. In deep brain stimulation, a battery is inserted into the brain and electrical current is delivered to some areas of the brain. Thanks to this, control of involuntary movements can be achieved.
Tourette syndrome usually does not cause any major problems in a person’s life. Therefore, there is no need for treatment. However, people who have problems in academic, social or business life because of their tics need treatment. Treatment improves the quality of life of these people. It would be beneficial to apply to a center equipped for the diagnosis and treatment of Tourette syndrome.
