Tourette syndrome: causes, symptoms, diagnosis and treatment

the Tourette syndrome it is a neurological disorder that causes the affected person to perform involuntary and aimless movements and sounds.

These movements are repeated intermittently and often increase in stressful situations. It is generally considered to be a particularly severe and chronic form of multiple tics.

In this article, we’ll take a look at what Tourette’s syndrome is and how it affects people who develop it.

What is Tourette’s syndrome?

The symptoms that appear in the early stages of development of Gilles de la Tourette syndrome begin between the ages of eight and eleven, the intensity of which varies widely. The affected person may suffer from periods of constant and frequent tics, and others in which the presence of these becomes practically non-existent. Boys are three to four times more likely to have Tourette’s syndrome than girls (1).

Tics can be classified as simple or complex tics:

  • simple tics: These are brief, involuntary, unexpected movements that affect a specific, limited number of muscle groups. Although they are presented in isolation, they are repetitive. Examples of this type of affectation are: moving your head, blinking your eyes, shrugging your shoulders, breathing hard through your nose …
  • Complex tics: coordinated and cyclical movements that affect various muscle groups, such as kicking, jumping, sniffing at objects or people, coprolalia (uttering unhealthy and obscene words in an uncontrolled manner), etc. In other words, they require a more complex and abstract type of mental processing.

Thus, Tourette’s syndrome is characterized by tics and problems inhibiting certain short behaviors, which are expressed in a few seconds or fractions of a second.

the causes

The causes of Tourette syndrome they are still unknown and there is no scientific consensus on this subject. Some hypotheses suggest that its origin may be linked to deficiencies in certain areas of the brain and alterations in chemicals (Dopamine, norepinephrine and serotonin) which ensure interneuronal communication.

Yes, Tourette’s syndrome has been scientifically proven to be one. hereditary illness and that an affected person has a 50% chance of transmitting the syndrome to their child. This gives clues as to the role that differences in the brain play compared to the rest of the population.

However, inheriting a genetic predisposition does not mean that the child will suffer from all of the symptoms associated with the disorder, but will be statistically more likely to develop it compared to the rest of the population. It is possible to have certain variants of genes which can never be expressed, or which are expressed in combination with other genes and which do not generate appreciable symptoms.

It has generally been observed that children of people with Tourette’s syndrome may have minor tics, Certain obsessive-compulsive behaviors, symptoms associated with attention deficit (no tics), or even a complete absence of symptoms. This indicates that Tourette’s syndrome could present in a very varied spectrum of intensities, and that it does not exist as a closed category and of equal severity in all.

On the other hand, it is assumed that the syndromes most characteristic of Tourette’s syndrome are due to failure in pulse regulation due to malfunctions in the frontal lobes, which are responsible for a large part of executive functions, and in the task of alleviating the desire to perform actions at this time.

symptoms

Tourette’s syndrome appears during a certain period of the first two decades of life, and within the same family nucleus there can be great variability in the presence of associated symptoms. Usually, the first expression of the syndrome is usually a facial tic, and it is common for each affected person to present their own limited repertoire of tics, always repeating the same thing.

Over time, people with Tourette’s syndrome show more motor tics of varying nature. They include both blinking or twitching of the facial muscles, making throaty sounds, sudden inhalation of air, scolding, shaking of the neck and head, etc. It is not known whether the appearance of complex tics is a cause of the previous appearance of simple tics, or whether the two phenomena are the result of an alteration that causes them in parallel.

Patients also express bothersome sensations in certain parts of the body, such as itching, pressure, tickling, itching … This type of tics is called sensitive tics.

Verbal tics are less common than most people think. Only 10% of patients present with echolalia (Repeat what you hear) or coprolalia (Unintentional emission of bad words or sentences). Some patients also express tics such as spitting up and / or copromime (offensive gestures).

The recurrence and intensity of tics may worsen or improve throughout the day and may vary over time. The pathology tends to improve during and after adolescence, during which the worst stage of Tourette’s syndrome is experienced, often linked to conduct disorders. Thus, the frequency of major tics and coprolalia (if any) is generally reduced from adolescence to adulthood.

How are people affected by this syndrome?

People with Tourette’s syndrome they have normal intelligenceAlthough they may have additional learning difficulties during childhood and adolescence, due to tics and associated behavioral and social conditions. These conditions are generally obsessive-compulsive disorder or attention deficit hyperactivity disorder (ADHD). It is also common for them to present conduct disorders (Social isolation, impulsiveness, aggressiveness) and sleep.

Impulsivity issues often lead to depression and anxiety, but these are not part of the neurobiology of the syndrome itself, but are part of the consequences of how it interacts with the environment and people. other.

Sometimes patients may be able to inhibit the tics over a period of time, but the tics eventually reappear more pronounced, as if it were a way to compensate for the inhibition. Thus, it seems desirable that the people around the patient are understanding and behave naturally in the presence of tics.

Some people have very mild symptoms that do not require treatment, and it is even common for their symptoms to go away over time.

treatment

No specific treatment is required for tics, except in cases of extreme severity or which cause muscle pain or disorders of school and social adjustment. In such cases, they are usually straightr neuroleptic drugs to reduce the intensity and frequency of tics., Although still under medical indication and under his supervision.

In terms of psychotherapy, it is effective in treating disorders related to Tourette’s syndrome, such as stress, depression or anxiety, learning and behavior problems, and the social and emotional consequences caused by the syndrome.

If the syndrome is accompanied by obsessive-compulsive disorder or ADHD, it will be necessary, apart from the therapies already explained, to treat these alterations in an appropriate way, which can negatively affect the quality of life of the person.

Three real cases

How do you feel about living with Tourette’s syndrome? Several people with notorious professional backgrounds bring us closer to this neurological syndrome.

1. Mahmoud Abdul-Rauf, an NBA player

Tourette can she suffer and be successful in life? The case of Mahmoud Abdul-Rauf (his birth name was Chris Jackson) is paradigmatic. We invite you to learn about his life in this article from the Spanish newspaper La Información.

2. Super Taldo: a Chilean boy with tics and coprolalia

An extreme case of Tourette’s syndrome is the one he suffered from Agustín Arenas, Called “Super Taldo”, a Chilean boy who became known through a journalistic report on Chilean television. You can find out their story by entering this link.

Finally: an in-depth documentary on this condition

A documentary produced by Xplora channel discovered the case of a 20-year-old boy diagnosed at the age of eight. In this brief excerpt from the report, the victim tells us what it is like to experience a day with constant tics. We suggest it to you below.

Bibliographical references:

  • Bloch, MH, Leckman JF (2009). Clinical course of Tourette’s syndrome. J Psychosom Res (Review) 67 (6): pages 497-501.
  • Cavanna, Andrea. (2010). Tourette syndrome. Publishing Alliance.
  • Leckman syndrome, JF, Cohen, DJ Tourette: tics, obsessions, compulsions: developmental psychopathology and clinical care. John Wiley & Sons, Inc., New York.
  • Moe, Barbara. (2000). Treat Gilles de la Tourette syndrome and tics. New York: Rosen Pub. Group.
  • O’Rourke, JA; Scharf, JM; Yu, D .; et al. (2009). The genetics of Tourette’s syndrome: a review. J Psychosom Res. 67 (6): pages 533 to 545.
  • (1) http://espanol.ninds.nih.gov/trastornos/sindrome_de_tourette.htm

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