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Tourette syndrome

Tourette syndrome — also called Tourette's syndrome, Tourette Spectrum
(TS), or Tourette's disorder — is a neurological or neurochemical
disorder characterized by tics — involuntary, rapid, sudden movements
or vocalizations that occur repeatedly in the same way. Symptoms include
multiple motor and one or more vocal tics present at some time during the
disorder although not necessarily simultaneously; the occurrence of tics
many times a day (usually in bouts) nearly every day or intermittently
throughout a span of more than one year; the periodic change in the number,
frequency, type and location of the tics, and in the waxing and waning of
their severity; symptoms disappearing for weeks or months at a time; and
onset before the age of 18.

The term "involuntary" used to describe TS tics is a source of confusion
since it is known that most people with TS do have some control over the
symptoms. What is recognized is that the control which can be exerted from
seconds to hours at a time may merely postpone more severe outbursts of
symptoms. Tics are experienced as irresistible as the urge to sneeze and
must eventually be expressed. People with TS often seek a secluded spot to
release their symptoms after delaying them in school or at work. Typically,
tics increase as a result of tension or stress (but are not caused by
stress) and decrease with relaxation or concentration on an absorbing task.

Individuals not only struggle with the condition itself, they must bear the
double burden of the stigma attached.

The majority of people with TS require no medication, but medication is
available to help when symptoms interfere with functioning. TS medications
are only able to help reduce specific symptoms. Neuroleptic and
antihypertensive drugs can have long- and short-term side effects, and use
of stimulants is controversial. Relaxation techniques and biofeedback may be
useful in alleviating stress.

There is no cure for TS, however, the condition in many individuals improves
as they mature. Individuals with TS can expect to live a normal life span.
Although TS is generally lifelong and chronic, it is not degenerative. In a
few cases, complete remission occurs after adolescence, and in many cases
total remission occurs after the age of 40.

Genetic studies indicate tic disorders, including TS, are inherited as a
dominant gene(s) that may produce varying symptoms in different family
members. A person with TS has about a 50% chance of passing the gene(s) to
one of his/her children. However, the gene(s) may express as TS, as a milder
tic disorder, or as obsessive compulsive symptoms with no tics at all. It is
known that a higher than usual incidence of milder tic disorders and
obsessive compulsive behaviours are more common in the families of TS
patients. The sex of the child also influences the expression of the
gene(s). The chance that the child of a person with TS will have the
disorder is at least three times higher for a son than for a daughter. Yet
only a minority of the children who inherit the gene(s) will have symptoms
severe enough to ever require medical attention. In some cases, TS may not
be inherited; these cases are identified as "sporadic" TS because a genetic
link cannot be found.

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