Tourette Syndrome, you might have seen this before

This a medical condition in which the individual uncontrollably move part of their bodies or produce unwanted sounds repeatedly. The affected individual might for instance repeatedly blink their eyes, shrug their shoulders, make some sounds or say offensive words unintended.

It affects children between the age of 2-16years. After teen age, the symptoms become less or become controllable.

There are 2 most common behavioural symptoms common in Tourette syndrome: Obsessive and Compulsive Disorder (OCD) and Attention Deficit and Hyperactivity Disorder (ADHD).

There is no cure for Tourette syndrome but it can be treated. The exact cause of this disease is unknown but many hypotheses have been raised related to the disorder.

SIGNS AND SYMPTOMS OF TOURETTE SYNDROME

Signs in Tourette syndrome can be divided into two- movement and vocal (sound) involvements. Each of these can be further classified into simple or complex.

MOVEMENT OR MUSCLE INVOLVEMENT

Simple motor tics: This involves limited number of muscle group. Example of movement are eye blinking or other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking.

Complex motor tics: This movement involves several muscle groups. Example of movements exhibited are: facial grimacing combined with head twist and a shoulder shrug. Other complex motor tics appear purposeful like sniffing or touching objects, hopping, jumping, bending or twisting.

Some of the most dramatic and disabling tics may include motor movements that result in self-harm such as punching oneself in the face.

VOCAL OR SOUND INVOLVEMENT

Simple vocal tics: This include repetitive throat clearing, sniffing, barking, or grunting sounds.

Complex vocal tics: This may include repeating one’s own words or phrases, repeating others’ words or phrases (called echolalia), or more rarely, using vulgar, obscene, or swear words (called coprolalia).

TREATMENT

In 2019, the American Academy of Neurology (AAN) released guidelines for treating tics in people with Tourette Syndrome. Recommendations address counseling, co-morbid disorders and treatment.

During the counseling session, the doctor informs the patients and caregivers about the natural history of tics and need for periodic evaluation to decide need for the ongoing treatment.

In situation where either ADHD or OCD is predominant, appropriate treatment should be initiated.

The choice of initiating treatment depends on the following factors: