Tourette Syndrome was named for Georges Gilles de la Tourette, who first described the syndrome in 1885.
Although the disease was identified in 1885, today in 1996, there still is a mystery surrounding Tourette Syndrome, its causes and possible cures. Tourette Syndrome is a neurological disorder that researchers believe is caused by and abnormal metabolism of the neurotransmitters dopamire and serotonin. It is genetically transmitted from parent to child. There is a fifty percent chance of passing the gene on from parent to child (Gaffy,Ottinger). Those most at risk are sons of mothers with Tourette Syndrome.
About three-quarters of Tourette Syndrome patients are male. Males with the disorder have a ninety-nine percent chance of displaying symptoms. Females, have a seventy percent chance of displaying symptoms. This ration of 3-4:1 for males and females may be accounted for by referral bias. Also, there is a frequent number of reported cases within the Mennonite religious isolate population in Canada.
The specific genetic transmission however, has not been established. Some researchers believe that the mar is on an autosomal dominant trait. Some cases however are sporadic, and there may not be a link to family history involved. These cases are mild however, and not full blown. The onset of Tourette Syndrome must be before the age of fifteen, and usually occurs after the age of two.
The mean age onset of motor tics is seven. The mean age onset for vocal tics is nine. In order for a person to be classified as having Tourette Syndrome they must have both multiple motor tics and vocal tics. These tics however do not have to occur everyday. In fact, affected individuals may rarely exhibit all of the symptoms, or all of the tics. The vocal and motor tics must also occur within the same year, for a person to be classified as having Tourette Syndrome.
Symptoms can disappear for weeks or months at a time. However if people afflicted with the syndrome try and suppress their tics, they will reoccur with increased ferver. Tics increase as a result of tension or stress, and decrease with relaxation or concentration on absorbing a task. Tics are classified into two groups: complex and simple tics. Simple tics are movements or vocalizations which are completely uncomprehendable and meaningless to those not suffering from the disorder (Peiss). Complex tics are movements or vocalizations which make use of more than one muscle group to appear to be meaningful (Peiss).
Simple motor tics are: eye blinking, head jerking, shoulder shrugging or facial grimacing. Simple vocal tics are: throat clearing, coughing, snorting, baiting, yelping. Examples of complex motor tics include: jumping, touching over people, and or things, smelling, stomping loudly, making obscene gestures, hitting or biting oneself. Complex vocal tics are any understandable words given out of context, and may including echoing and repetition.
Other problems associated with Tourette Syndrome include Attention-Deficit Disorder, Hyperactivity Disorder, disinhibition, obsessive compulsive disorder, dyslexia and other various learning disabilities, and various sleep disorders. People with Tourette Syndrome do tend to present more other Axis 1 disorders than the rest of the normal population not afflicted with the syndrome. People with Tourette Syndrome are also afflicted with obsessions of contamination, disease, sexual impulses, self harm, being just right, and death. Sixty percent of those who are diagnosed as having Tourette Syndrome will also display some type of learning disorder. Such disorders include: having difficulty organizing work, having difficulty playing quietly, talking excessively, interrupting and intruding on others, having a shorter attention span, losing necessary materials for school and home, and engaging in physically dangerous activity, with no thought given to the ramifications of their actions. Attention-Deficit/Hyperactivity Disorder is also found in sixty percent of those with Tourette Syndrome.
Those with ADHD are easily distracted, has difficulty getting along in groups, shifts from activity to activity, often blurts out answers before asked, and fidgets with hands, feet, or squirms in seat. Although these symptoms may seem fairly similar it Tourette Syndrome, it is important to remember that Tourette Syndrome is a genetically inherited disease. These other complexes are merely brought on by the neurological imbalance which affects the brain of those afflicted. Tourette Syndrome cannot be treated as a whole. Medications must be issued for the different aspects of the disease. For example, Tics and movements are treated with Neuoleptics, Clonidine and SErotonin Drugs, which are prozac-like.
These drugs are very good for treating muscle spasms as well as tremors. However the side effects may be unpleasant. Therefore the patients under such drugs must be monitored for the liver and heart. The Medical Treatment for OCD is augmenting dopamine agents (Orap) or Klonopin.
These drugs help curtail depression, but how genital-urinary side-effects. The ADHD in Tourette Syndrome are treated with Ritalin because the tics may not increase if used in reasonable dosages. Hyperactivity is also curtailed. The side effects of Ritalin are urinary problems, skin changes, EEG monitor, and EKG monitor as well. The Tics may also be controlled by visits to doctors office, talking to friends, and staying away from social gatherings, and learning to deal with emotional trauma.
Help however is available for Tourette Syndrome. The goals of health professionals concerning this disorder is to clarify reasons for school problems, and to develop and individualized multimodality treatment program.
