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What is Tourette syndrome?
What are the symptoms?
What is the course of TS?
Can people with TS control their tics?
What causes TS?
What disorders are associated with TS?
How is TS diagnosed?
How is TS treated?
Is TS inherited?
What is the prognosis?
What is the best educational setting for children with TS?
Where can I get more information?
What is Tourette syndrome?
Tourette syndrome (TS) is a neurological disorder characterized by
repetitive, stereotyped, involuntary movements and vocalizations called tics.
The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering
French neurologist who in 1885 first described the condition in an 86-year-old
French noblewoman.
The early symptoms of TS are almost always
noticed first in childhood, with
the average onset between the ages of 7 and 10 years. TS occurs in people from
all ethnic groups; males are affected about three to four times more often than
females. It is estimated that 200,000 Americans have the most severe form of TS,
and as many as one in 100 exhibit milder and less complex symptoms such as
chronic motor or vocal tics or transient tics of childhood. Although TS can be a
chronic condition with
symptoms lasting a lifetime, most people with the
condition experience their worst symptoms in their early teens, with improvement
occurring in the late teens and continuing into adulthood.
Tics are classified as either simple or complex. Simple motor tics are
sudden, brief, repetitive movements that involve a limited number of muscle
groups. Some of the more common simple tics include eye blinking and other
vision irregularities, facial grimacing, shoulder shrugging, and head or
shoulder jerking. Simple vocalizations might include repetitive throat-clearing,
sniffing, or grunting sounds. 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. Simple vocal tics may include
throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal
tics include words or phrases. Perhaps the most dramatic and disabling tics
include motor movements that result in self-harm such as punching oneself in the
face or vocal tics including coprolalia (uttering swear words) or echolalia
(repeating the words or phrases of others). Some tics are preceded by an urge or
sensation in the affected muscle group, commonly called a premonitory urge. Some
with TS will describe a need to complete a tic in a certain way or a certain
number of times in order to relieve the urge or decrease the sensation.
Tics are often
worse with excitement or anxiety and better during calm,
focused activities. Certain physical experiences can trigger or worsen tics, for
example tight collars may trigger neck tics, or hearing another person sniff or
throat-clear may trigger similar sounds. Tics do not go away during sleep but
are often significantly diminished.
What is the course of TS?
Tics come and go over time, varying in type, frequency, location, and
severity. The first symptoms usually occur in the head and neck area and may
progress to include muscles of the trunk and extremities. Motor tics generally
precede the development of vocal tics and simple tics often precede complex
tics. Most patients experience peak tic severity before the mid-teen years with
improvement for the majority of patients in the late teen years and early
adulthood. Approximately 10 percent of those affected have a progressive or
disabling course that lasts into adulthood.
continue: Causes, Co-Morbid Conditions, and
Diagnosis of Tourette Syndrome
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Reviewed: 03/2006
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