Tourette’s Syndrome What Makes Them Tic? Tourette’s syndrome is a neurological disorder, which involves involuntary body movements or Tics. There are two types of Tics, motor/physical and vocal. This paper will cover many aspects of Tourette’s syndrome; including the history of the disease, the discovered of the disease, the genetics involved with the disorder, the diagnosis of the disease, and the effects of the disease on families. George Gils de la Tourette’s a French doctor and biologist discovered Tourette’s syndrome in 1885 (Landau 21). He was observing patients with unexplained repetitive movements and could not find any preexisting condition that would cause these symptoms. After extensive research he concluded that this disorder had not been documented before, so he named it Tourette’s syndrome, after himself.
Tourette’s syndrome is a neurological disorder; it is inherited from a parent’s dominant gene, causing different symptoms among different family members. It is not known on which chromosome the disease is located. There is a 50% chance that one will pass this trait on to his/her offspring with each pregnancy (Shimberg 64). There is no prenatal testing that can be done before a child is born to determine if the child has the disease. Unlike other genetic disorders or disease Tourette’s is not in the blood.
Therefore testing will not give any indication of whether or not a child will develop Tourette’s. Cases of the disease show males are burden with the disease three to four times more often then females. There is a 15% chance that the disorder will evolve during childhood. Both motor and vocal tics become less frequent with age but unfortunately will never Thursfield 2 disappear. The U.S.
Medical Survey estimates that 100,000 people have full blown Tourette’s syndrome, and there are up to 300,0000 have minor undiagnosed cases. Tourette’s Syndrome causes an individual to lose control of body movement resulting in repetitive actions and verbalizations. These involuntary movements are called tics. There are two kinds of tics, motor/physical and vocal. Motor tics can be simple or complex in appearance.
Simple motor tics are abrupt, sudden, and brief movements, occurring in a single or isolated manner. Examples of simple motor tics include eye blinking, head jerking, shoulder shrugging and facial grimacing. Complex tics are distinct, coordinated patterns of sequential movements. Examples of complex tics include such acts as touching the nose, touching other people, smelling objects, jumping, copropraxia (obscene gestures), and echopraxia (mimicking movements preformed by others), head shaking associated with shoulder shrugging, and repetitive kicking of the legs (Shimber 25). Complex physical tics among Tourette’s patients are uncommon and only found among a small population. Motor tics usually recur in the same part of the body, and multiple regions of the body can be involved.
The expressions of the tics are not necessarily identical from occurrence to occurrence, even within the same body part. Tics often recede from one part of the body and evolve elsewhere. Vocal or phonic tics are caused by air moving through the mouth, nose, or throat. Vocal tics can be subdivided into simple and complex. Simple vocal tics include sounds, groans, grunting, hissing, gurgling, gasping, belching, screaming, snorting, shouting, puffing and other mouth noises. Complex vocal tics consist of uttering words or phrases out of context and coprolalia (vocalizing socially unacceptable words).
Thursfield 3 There are several associated behaviors in addition to the tics that Tourette’s patients suffer from. One of the most common disorders is Attention Deficit Disorder with or without Hyperactivity (ADD or ADHD). Symptoms of ADD may include: difficulty with concentration, falling to finish what is started, not listening, and often acting before thinking (Shimberg 74). Tourette’s patients may also suffer from obsession and or exhibit sleeping disorders. Obsession consists of repetitive unwanted or bothersome thoughts. Those patients that suffer from sleeping disorders may frequently walk or talk in his/her sleep.
A typical case of Tourette’s syndrome is hard to define because the symptoms fall within a wild spectrum from mild to sever. Observing symptoms and evaluating one who exhibits characteristics of Tourette’s syndrome is the only way to make a diagnosis. Since, this is a neurological disorder there are no x rays, scans, blood or neurological test that can be preformed to determine if this is the condition that one is suffering from (Comings 542). The onset of this disease is generally before the age of eighteen; this fact helps to narrow down the diagnosis of the disorder. Tourette’s is a manageable disease for the patient and family, and patients can usually live a fairly normal life.
Unlike other genetic diseases like Muscular Dystrophy, and Cystic Fibrosis, which can leave a patient fully dependent on others to care for them, the Tourette’s Syndrome patients are able to support and care for themselves. This disorder does not affect a person’s intelligence or ability to learn at all. A person with Tourette’s syndrome can have some control of their tics. They can hold in their tics and go into a bathroom or other private place to release them. Thursfield 4 The majority of tourette’s patients are not dramatically disables by their tics and they do not require medicine. For those who have sever tics, that interfere with the way that they function are given medications to help control the symptoms.
The medications that are used to treat Tourette’s syndrome are categorized as antiphsychotics, strong medications. The ones most commonly used to treat the disorder are Haloperidol, Clonidine, Pimozide as well as Ritalin for hyperactive patients. There can be serious risks and side effects with these medications. The most important severe reaction to these medications is a condition called Tardive Dyskensia, which in its self causes involuntary muscle jerking and stiffness. These medications may also cause drowsiness and sedation.
Two minor side effects are dry mouth and sensitivity to sunlight. Patients must be closely monitored while taking these medications. Since they may make people prone to seizures and affect their heart. Side effects from this medication can occur at any time while on the drug, even years after starting on the drug. It is very important that the patient has the correct diagnosis before beginning any of these medications. It can cause serious problems for the patient if they are taking these medicines and they don’t have a neurological disorder. Psychotherapy is another treatment that allows patients to be taught substitutions for his/her tics.
Anatomy and Physiology.