By Dr Ananya Mandal, MD
Tourette syndrome is a neurological condition affecting the brain and nervous system. It is typically characterized by involuntary movements and noises known of as tics. The disease was named after a French physician called Georges Gilles de la Tourette who first described the condition in the 19th century.
In most people who develop the condition, the symptoms begin during childhood and continue into adulthood. It may be associated with mental health conditions such as obsessive compulsive disorder or attention deficit hyperactivity disorder.
A person with Tourette syndrome usually makes a combination of involuntary movements or noises called tics. Tics may be vocal in nature (phonic tics) and include involuntary grunting, clearing of the throat, coughing or the shouting of words. Tics may also be physical movements (motor tics) such as jerking or shaking the head or jumping up and down.
Tics may be simple, with an individual only uttering a single sound or they may be complex and involve a series of physical movements and lengthy spoken phrases.
For many people with Tourette syndrome, there is a combination of physical and vocal tics that may be either simple, complex or both. The tics may not affect the person's health severely but they can be embarrassing and also some head jerks or other physical movements can cause pain. Social problems associated with Tourette syndrome include social isolation and low self-esteem leading to depression and anxiety.
Cause of Tourette syndrome
The exact cause of this condition is unknown. However, there is speculation that this condition may be linked to problems in the basal ganglia of the brain, which is involved in the regulation of movements. The basal ganglia are thought to "misfire" in a person with Tourette syndrome, giving rise to the characteristic tics.
Treatment of Tourette syndrome
The condition is incurable but treatment is aimed at controlling symptoms of the condition. Once a child is diagnosed with Tourette syndrome, a treatment plan is usually developed by a multidisciplinary team including a neurologist, a paediatrician, a psychiatrist and a counsellor, for example.
Behavioral therapy has been shown to reduce the intensity and negative effects of tics in some individuals. One example of behavioural therapy that can help achieve this is habit reversal therapy, which involves identifying any sensations that triggers a tic and trying to find another way to relieve the sensation.
Another type of behavioural therapy involves increasing exposure to the sensation that causes an urge to tic and suppressing the tic for as long as possible, the theory being that the patient will eventually be able to withstand the urge to tic until it passes.
For more frequent or severe tics, medications that may be prescribed include alpha2-adrenergic agonists, dopamine antagonists and muscle relaxants. Surgery may be recommended for very severe cases, but this is extremely rare.
In around two thirds of all people with Tourette syndrome, symptoms start to significantly improve about ten years after their onset and medications and other therapy may not be needed as symptoms become less frequent and severe and eventually disappear.
In the remaining third of sufferers, the symptoms continue to persist throughout life, although they usually become milder as a person ages, meaning the need to use medication and therapy may eventually pass.
Reviewed by Sally Robertson, BSc