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December 11, 2017

What is Tourette Syndrome?


Tourette syndrome is a neurological disorder characterized by repetitive, involuntary movements and vocalizations which are called “tics.” The disorder is named for Dr. Georges Gilles de la Tourette, a pioneering French neurologist who first described this condition in the case of an 86-year old French woman way back in 1885. While the first documented and official case revolved around an elderly woman, modern day psychology shows that the earliest symptoms of the disorder are noticed between the ages of three to nine years old. It occurs equally in all ethnic groups, but males are affected about three to four times more than females. 

At least 200,000 American citizens have been estimated to have the most severe form of Tourette Syndrome, and at least one hundred showcase the less complex symptoms such as but not limited too vocal or motor tics. Although Tourette Syndrome is usually a chronic and incurable condition that lasts an entire lifetime, most people experience their worst symptoms in their early-to-mid teenage years. Improvement usually occurs before adulthood, but some cases never reach that stage.

What Are Tics?

Tics are present in every case of Tourettes. Sometimes simple, sometimes complex, these tics are broken up into motor and vocal problems.

Motor tics are sudden, brief, and repetitive movements that include but are not limited to rapid eye blinking, facial grimacing, shoulder shrugging, and shoulder jerking. They move quicker and last longer, causing more harm and annoyance to the victim of the disorder, as they get more complex. Eventually they might combine, causing grimacing mixed with head twists and uncontrollable shrugging. They may appear purposeful, but are simply random jolts of uncontrollable movement. These motor tics become, in the worst cases, movements that result in serious self-harm, such as repeated punches into one’s face. They can be influenced by physical experiences that “trigger” them, such as tight collars or specific smells. The very first symptoms of motor tics usually occur in the head and neck area and may expand to include muscles of the abdomen and limbs. Motor tics usually precede the development of vocal tics, and simple tics often precede complex tics.

Vocal tics include repetitive throat-clearing, sniffing, or grunting noises that are beyond the person’s control. As they get more complex, vocal tics might evolve into screaming specific words or phrases out of nowhere. Most if not all patients suffering from Tourettes Syndrome have absolutely no idea where the word or phrase came from. These vocal tics become, in the worst cases, coprolalia. Coprolalia is the loud and repeated uttering of socially inappropriate words, such as swearing and cussing, and is only present in ten to fifteen percent of individuals with the disorder. Some people suffering in chronic cases of Tourettes gain a slight problem in which they whisper to themselves everything they say to others. Sometimes the syndrome leads to echolalia, the repeating of words that people around them say. They, too, can be influenced by experiences around them, such as hearing another person speak or clear their throat.

Tics must be expressed, even if they go against the person’s will.

What Causes Tourette Syndrome?

The cause of the disorder is unknown, but modern day research points to abnormalities in specific brain regions (the basal ganglia, frontal lobes, and cortex). Many psychologists believe the “circuits” that connect the regions of the brain might be what cause the disorder, but little to no evidence can point to the exact cause of Tourette Syndrome.

Unfortunately, there is no medication that is helpful to all people with the disorder, nor does any medication effectively and completely eliminate symptoms.  In addition, all these medications have incredibly dangerous side effects. Just as the cause of the problem is unknown, the solution remains hidden as well.

Who Might Have Had Tourettes?

Wolfgang Amadeus Mozart: The famous composer might have had Tourette Syndrome. In 1992, the British Medical Journal published an article claiming that Mozart had Tourette Syndrome. It has been documented several times that he was hyperactive, suffered from mood swings, had motor and vocal tics, and loved made-up words. Despite these behaviors, we will probably never know for certain whether Mozart had the disorder, as he lived before the discovery of the symptoms.

References

  1. Singer HS. “Tourette syndrome and other tic disorders”.
  2. Bloch, State, Pittenger 2011. See also Schapiro 2002 and Coffey BJ, Park KS. “Behavioral and emotional aspects of Tourette syndrome”. Neurol Clin. 1997 May;15(2):277–89.
  3. Cohen DJ, Jankovic J, Goetz CG, (eds). Advances in neurology, Tourette syndrome. Lippincott, Williams & Wilkins, Philadelphia, PA. 2001;85:xviii.
  4. “Autism spectrum disorders: relevance to Tourette syndrome”. Adv Neurol. 2001;85:89–101.
  5. van de Wetering BJ, Heutink P. “The genetics of the Gilles de la Tourette syndrome: a review”. J Lab Clin Med. 1993 May
  6. Did Mozart really have TS? by the Tourette Syndrome Association.

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