Tourette Syndrome (TS)

August 11, 2015

According to the Centers for Disease Control “1 of every 360 children 6 through 17 years of age and living in the United States have been diagnosed with TS.   That represents approximately 138,000 children.”  In addition, among children diagnosed with TS, 86% also have been diagnosed with at least one additional mental health, behavioral, or developmental condition including 35% of children on the autism spectrum.  (Source: CDC) Unfortunately, understanding the frequency of TS is only one part of the story.  Let’s look at the symptoms, diagnosis and treatment of this neurological disorder.

What is Tourette syndrome?

Symptoms of Tourette Syndrome usually start in childhood with involuntary movements (tics) of the face, arms, limbs or trunk. The most common tic that is reported as an initial symptom is the facial tic (eye blink, nose twitch, grimace). As the syndrome progresses these tics may be replaced or added to by other tics of the limbs, neck and trunk.  There are several types of tics that may impact a child such as:

• Simple Tics – These tics are sudden and brief repetitive movements that involve usually one group of muscles.
• Complex Tics– are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting.(Source: National Institute of Neurological Disorders)
• Vocal Tics – These tics may include grunting, sniffing, coughing, barking, shouting a word or clearing the throat.  Vocal tics can be broken down even further into coprolalia (the involuntary use of obscene words or socially inappropriate words and phrases) or copropraxia (obscene gestures). Echo phenomena (echo speech or echolalia) are also reported, although less frequently.

For a medical diagnosis through the Diagnostic and Statistical Manual of Psychological Disorders V, the tics, whether vocal or physical must be present for a year, not caused by prescription drugs and the symptoms must have begun before the 18th birthday.

Treatment of Tourette Syndrome can vary depending upon the severity of the tics.  For a large number of people afflicted by these tics, they seem to peak in the teen years and dissipate as they move into adulthood.  Unfortunately, approximately 10-15 percent of those affected have a progressive or disabling course that lasts into adulthood. People in this grouping may need to seek medical assistance for the tics.  There is no one miracle drug treatment for this since each affects the patient in a different way.  Neuroleptics (drugs that may be used to treat psychotic and non-psychotic disorders) are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide). A complete consult with a medical professional specializing in Tourettes Syndrome would be able to guide families in the treatment that will be most helpful.