Nouchine Hadjikhani discusses Tourette syndrome, presentation of Tourette, prevalence, and causes.
Tourette syndrome is a neurodevelopmental abnormality manifesting as tics in different parts of the body. Tics are involuntary, and motor and vocal tics (e.g. facial twitches and various abrupt sounds) can occur coincidingly. They are often associated with additional symptoms (lacking impulse control, obsessive compulsions and attention deficit). Gilles de la Tourette, a French doctor, was the first to describe this disorder in 1885.
A combination of at least two motor tics and one vocal tic that have lasted for at least a year are necessary to diagnose Tourette Syndrome.
Presentation of Tourette
Some of the motor tics are simple, such as rapid eye blinking, nose twitching, shoulder shrugging, but they can also be quite complex and result in hopping, jumping, kicking or spinning.
Vocal tics generally appear later than motor tics, and just as the motor tics, they can be simple (sniffing, clearing throat, grunting) or complex, including repeating words of others (echolalia) or repeating one own’s words (palilalia). It is also not uncommon that people with Tourette syndrome have coprolalia, that is the involuntary use of obscene or swear words.
Not rarely is the simultaneous occurrence of ADHD and OCD (Obsessive Compulsive Disorder) the most problematic issue for the person suffering from Tourette syndrome. Motor and vocal tics also exist as isolated conditions but in these cases the person in question is not diagnosed with Tourette syndrome.
Symptoms can worsen due to relaxation but also as a result of stress.
How common is Tourette?
Around 1% of all children and perhaps 0.5% of all adults are functionally impaired due to Tourette syndrome.
Tourette – gender and age
Tourette is 3-4 times more common in boys than in girls. Tics often appear during childhood (5-7 years), most often as motor tics, and they tend to increase in frequency and severity in preadolescence. In many people, they improve during late adolescence, but for some they persist into adulthood.
What causes Tourette?
Tourette syndrome is often hereditary and tics can generally be found in other relatives. Tourette is, like other neurodevelopmental disorders, the result of a complex interaction between genes and environment. Infections and stress of other kinds (as well as extreme relaxation) can trigger tics in many cases.
Alternative and additional diagnoses
Tourette syndrome is often associated with ADHD or "subclinical" ADHD; OCD; Autism Spectrum Disorder. Other associated conditions include anxiety, depression and sleep problems.
Treatment of Tourette
If the tics do not interfere with daily life, no treatment is needed. In severe cases, treatment options include cognitive behavioral therapy and medication therapy.