Tourette syndrome leads to chronic tics or tic disorders. Tics are involuntarily occurring sounds or words, which are usually accompanied by equally uncontrolled, jerky and rapid movements (e.g. twitching).
What is Tourette Syndrome?
Tourette ‘s syndrome is a neurological-psychiatric disease whose causes have not yet been fully clarified. The name of the disease goes back to the French neurologist Georges Gilles de la Tourette, who scientifically described Tourette syndrome for the first time in 1885. For flat foot dictionary definitions, please visit foodanddrinkjournal.com.
Characteristic symptoms of Tourette’s syndrome are motor and vocal tics, ie sudden, uncontrolled, arrhythmic movements of certain muscle groups (motor tics) and uncontrolled vocalizations (vocal tics). The uncontrollable tendency to make obscene statements (coprolalia), which is often associated with Tourette’s syndrome, can only be observed in about one fifth of those affected and is not a characteristic symptom of Tourette’s syndrome.
In addition, symptoms such as AD(H)S, compulsive actions, anxiety and obsessive-compulsive disorders and depression can be observed in those affected by Tourette’s syndrome (comorbidity).
Causes
Tourette syndrome can be genetic and non-genetic. According to recent studies, not a single gene but several genes are responsible for the inheritance of Tourette’s syndrome in genetically determined Tourette’s syndrome, although these, as well as the exact mechanism of inheritance, have not yet been able to be determined one hundred percent.
It is certain that the children of a parent who has Tourette’s syndrome have a 50 percent chance of inheriting the disease and that men are affected more often than women.
In addition, Tourette’s syndrome is attributed to a disturbed metabolism in the dopaminergic system of the brain. The neurotransmitter dopamine is overactive in sufferers of Tourette’s syndrome and leads to motor dysfunction. This metabolic imbalance is amplified by emotional stimuli (such as stress, joy) and triggers the tics typical of Tourette syndrome.
In a very small proportion of those affected by Tourette’s syndrome, a bacterial streptococcal infection in childhood (such as scarlet fever, tonsillitis) is suspected to be the trigger of the disease (PANDAS syndrome).
Symptoms, Ailments & Signs
People have repetitive rapid physical movements (motor tics), vocalizations (vocal tics), or a combination of the two that serve no purpose. Those affected can delay the tics, but cannot suppress them. If Tourette’s syndrome is present, there is a combination of several motor tics with at least one vocal tic.
In many cases, simple motor tics such as blinking the eyes, grimacing, jerking the head or jerking the shoulders occur. More rarely, complex motor tics such as jumping, touching people and objects, copropraxia (performing obscene gestures), body twisting, or smelling occur. Another symptom is repetitive self-injurious behavior.
For example, people may bang their head against the wall or certain objects, hit themselves, or pinch themselves. Simple vocal tics that commonly occur include grunts, squeaks, throat clearing, squeaking, tongue clicking, or sniffing. Those affected often also suffer from complex vocal tics such as coprolalia (uttering obscene words), echolalia (repeating sounds or fragments of words just heard) or palilalia (repeating words just spoken).
In conversations, those affected tend to suddenly throw out words and short sentences that are unrelated to the topic of conversation. Depression, sleep disorders, learning difficulties and general restlessness are also associated with Tourette’s syndrome.
Diagnosis & History
There are no neuro-psychological diagnostic procedures for Tourette’s syndrome, the diagnosis is made exclusively on the basis of the symptoms, ie the existing symptoms. Tourette syndrome is present if at least two motor tics and one vocal tic are observable for at least one year before the age of 21. Most people affected by Tourette’s syndrome develop it between the ages of 6 and 8.
Tourette’s syndrome has a chronic course and is characterized by a gradual onset of the disease. In the further course of the disease, the tics are subject to strong fluctuations in terms of both intensity and frequency and reach their strongest expression mainly during puberty. The majority of people affected by Tourette syndrome experience a marked decrease in tics in adulthood.
Complications
The tic and Tourette syndrome has a very negative effect on the quality of life of those affected and can also lead to strong social tensions. The tics and disorders can seem very strange, especially to outsiders, so that those affected are often bullied or teased. However, in some cases there are also aggressive actions against the sick.
During puberty, the tic and Tourette syndrome can lead to severe mental health problems or depression. Various muscle groups are also involuntarily moved by the syndrome, which can lead to twitching and possibly even cramps. In many cases, however, the severity of the syndrome decreases with age, so that the everyday life of those affected returns to normal.
A causal treatment of the tic and Tourette syndrome is unfortunately not possible. Those affected are dependent on various therapies that can alleviate the symptoms and limit the tics. However, a positive course cannot be guaranteed. Medications can also be taken. There are no complications. The life expectancy of the patient is usually not negatively affected by the tic and Tourette syndrome.
When should you go to the doctor?
In the event of abnormal behavior or motor skills, a special duty of care must be exercised. A doctor is needed as soon as there are involuntary or uncontrollable movement impulses or other peculiarities. A loss of control over vocalization is a warning signal from the organism. A doctor is needed to initiate a causal research. Sleep disorders, general restlessness, nervousness and concentration problems indicate irregularities.
The complaints must be presented to a doctor because the person concerned needs medical care. The repetition of sounds just heard without any rationale behind the process is considered a cause for concern. In the case of self-injurious behavior, a doctor should be consulted as soon as possible. Beating your hands on the wall, banging your head on objects, or unusual twisting of your body are all signs of a disease.
Those affected cannot explain their actions and in most cases have no triggering stimulus. If words or parts of a sentence come out of the mouth of the person concerned without control, a doctor must be informed of the observations. Performing obscene gestures, insults, or other unpleasant actions are also part of the condition. Disorders of memory activity, learning difficulties or withdrawal behavior from participation in social life should be discussed with a doctor.
Treatment & Therapy
Because the causes of Tourette’s syndrome have not yet been fully clarified, it cannot be cured with medication or psychotherapy. Accordingly, only the symptoms of Tourette’s syndrome can be alleviated with the help of pharmacological and/or psychological therapy measures.
Within the framework of psychotherapeutic measures, methods for coping with stress and relaxation techniques can be learned. Particularly positive results are achieved by the so-called reaction-reverse method, in which those affected by Tourette’s syndrome are trained to perceive the first signs of possible tics and learn to develop counter-regulation mechanisms.
However, additional drug treatment should only be considered if the symptoms are particularly pronounced and are perceived as bothersome. The pharmacological treatment methods developed so far do not address the cause, but rather the symptoms.
Good results are achieved in this regard with dopamine antagonists. These are bound by the receptors of the messenger substance dopamine and prevent the messenger substance from docking, so that it is blocked and the metabolic imbalance in the dopaminergic system described above is minimized. A drug from this group that is used in many cases in Germany is tiapride.
Prevention
There are no preventive measures for Tourette’s syndrome . Nevertheless, it makes sense to avoid stressful situations or to learn how to deal with them. According to some studies, while some non-genetic, environmental, or psychosocial factors may not cause Tourette’s syndrome, they can affect the severity and severity of the condition. For example, smoking and stress during pregnancy and complications during childbirth are risk factors that can increase the development of the tics typical of Tourette’s syndrome.
Aftercare
According to the current state of knowledge, Tourette’s syndrome is not completely curable. The disease can only be alleviated with medication. The patient must be able to cope with his tics in everyday life for the rest of his life. For this reason, follow-up care makes sense. It is carried out using behavioral therapy under the guidance of a specialist doctor or psychologist. The aim of follow-up care is to deal with the syndrome appropriately.
As part of the aftercare, the patient learns ways to control impulses. Regular appointments with a behavioral therapist are necessary for a successful recovery. Those affected by Tourette’s syndrome often experience a lack of understanding and rejection in their environment. They form a risk group for bullying in the workplace. In the family environment, the patient can also feel rejected.
The result is depression or reduced self-confidence. In this case, follow-up care is psychotherapeutic. The prevention of mental disorders has priority here. She involves loved ones if they feel overwhelmed by the patient’s condition.
Tourette’s patients can take up a normal job. Many of them have a strong creativity. Aftercare is aimed at working out and (professionally) implementing the individual talent. Becoming aware of one’s own abilities increases the patient’s self-confidence.
You can do that yourself
Tourette’s syndrome is a neurological disease of the nervous system that is predominantly genetic. It is usually chronic, so it is neither curable nor treatable. Only the symptoms can be improved by pharmacological or psychological behavioral therapy.
Behavioral therapy can use targeted exercises to reduce or specifically suppress tics, which improves or halfway normalizes the everyday life of the affected person. The “Habit-Reversal-Training” should be mentioned in particular, which is considered to be a particularly helpful form of treating tics. In Germany, however, there are still not very many experienced therapists. It should also be noted that this measure is usually only effective if the severity of the symptoms is not yet too pronounced. It also depends on how long the person concerned has been suffering from his tics.
A much more important measure would be the sensitization or clarification of the personal environment. Since tics are perceived frequently and strongly in public, the psychological suffering of those affected is very high. Both Tourette syndrome and tics are met with anger, astonishment and rejection in those affected, which can lead to mutual exclusion. Many people feel particularly provoked by the vocal tics and cannot imagine that they are part of an illness. For this reason, it is important to educate the environment to avoid shame and ridicule and to integrate the people concerned.
