Tourette’s syndrome is a chronic neurological disorder that results in the presence of certain tics, simple or complex, starting before the age of the 18 years. Tics are meaningless, involuntary, rapid, and recurrent movements (motor tics) and vocalizations (vocal tics) out of context.
It’s frequency and intensity are variable. Tourette syndrome is three times more common in men than in women. Tics can persist into adulthood in approximately one percent of children. Tourette’s syndrome was first described in 1885 by French neurologist George Gilles de la Tourette.
Start of the Disease
Tourette syndrome tics usually appear between the ages of five and seven but tend to increase in intensity between the ages of 8 and 12 starting with simple movements like blinking the eyes or moving the hands and arms, which then worsen and develop repeated words, sudden movements and sounds like barking, grunting, yelling or swearing for example. Most tics disappear in early adulthood.
Diagnosis
Having a tic is not enough to say you have tourette syndrome. Diagnosis is made throughclinical manifestations and their evolution. The doctor may ask other tests such as an electroencephalogram or an MRI to rule out other illnesses. This syndrome can be confused with
other pathologies such as obsessive-compulsive disorder, anxiety or hyperactivity disorder and attention deficit disorder. It can also be associated with learning problems . Tourette syndrome is diagnosed by the presence of motor and vocal tics lasting more than one year.
Types os Tics
There are three main types of tic disorder: temporary tic disorder, which is when a person has had
motor and/or vocal tics for less than a year; persistent tic disorder, which is when the person has had motor or vocal tics but not both, for more than a year; tourette syndrome which is when a person has had both motor and vocal tics for more than a year. Children usually start out with temporary tic disorder and sometimes end up developing persistent tic disorder or tourette syndrome.
Associated Pathologies
Children with severe tic disorders or tourette syndrome are more likely to have another disorder, such as
compulsive disorder and attention deficit disorder with hyperactivity and learning disabilities. These problems appear to be a result of brain abnormalities that cause the tics that cause tics and tourette syndrome. However, a tic disorder is serious. The extraordinary stresses of living with these disorders can make problems worse.
Tics
Before a tic occurs, the person may feel a compulsion to do it. This compulsion is similar to the need to sneeze or scratch. Tension usually builds up in the affected part of the body. Giving in to the tic compulsion offers brief relief. Sometimes tic that can be postponed for a few seconds to minutes but only through conscious effort and with difficulty. Drawing attention to tic, especially in children, can get worse.
Coprolalia, Copropraxis e Echolalia
Tics usually do not occur during sleep and rarely interfere with coordination, tics can improve when people are concentrating on a task such as school or work activities or when people are in an unknown location.
Mild tics rarely cause the problem but get serious as coprolalia copropraxis or echolalia can cause social problems coprolalia is the involuntary tendency to utter obscene words or make comments generally considered socially derogatory and therefore inappropriate. Copropraxis is a tic that consists of involuntarily performing obscene gestures or inappropriate touching
Echolalia is a language disorder characterized by repetitive lack.
Controllability
Some people are able to suppress tics during social situations but others have difficulty controlling them, especially if they are experiencing moment of emotional stress, which can make your school and professional life difficult . In some cases the tics may improve and even disappear after adolescence, but in other people these tics may persist into adulthood.
Treatment
If the person’s clinical condition is not severe, a limited number of consultations with psychologists may be enough to reassure him and change the way he treats the tic. If the symptoms were mild, the best thing is to reassure the person and pay as little attention to the tic as possible until it disappears by itself. Treatment can often be avoided if your family understands the disorder and if the disorder is explained and understood by the child’s teachers and schoolmates. Each case is different, as far as treatment is concerned. The therapeutic arsenal includes, for example, anxiolytics, neuroleptics, etc… In the last case, there is the possibility of deep brain stimulation.
Deep Brain Stimulation
Deep brain stimulation is an elective surgical procedure in which electrodes are implanted in certain areas of the brain. These electrodes generate electrical impulses that control abnormal brain activity . This type of procedure, like any other surgical intervention, is subject to complications such as infection and bleeding. In the treatment of tourette syndrome symptoms, it should only be indicated after an attempt to control it with drug and behavioral treatment.