Tourette’s Syndrome is a rare and complex neuropsychiatric condition that is most well-known for the involuntary tics it causes an individual to emote. Despite its rarity, Tourette’s often presents itself in conjunction with other disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), Learning Disorders and Anxiety. Although it is still unclear what the exact cause of Tourette’s Syndrome is, it has been documented that it occurs more commonly in males than females by a ratio of five to one and is not exclusive to any one ethnicity.
The most common sign of Tourette’s Syndrome and one of the main reasons for it being considered a condition warranting the attention of professionals are tics. These can be grouped into two main categories, which are motor tics (body movements) and vocal tics (phonic sounds), and are generally observed as being involuntary, repetitive and frequent of which can vary in type and intensity. There are, in fact, many clinical varieties of tics that can affect numerous parts of the body. However, the most common are those concerning the face, torso and shoulders.
It’s also important to point out that there are two further sub-categories within each of the motor and vocal varieties. Both can present themselves as either simple or complex, making a list of four sub-types in total. In the case of motor tics, a simple tic would involve the movement of just one muscle, while a complex tic might involve a full-body movement, engaging several parts of the body. The same also applies to vocal tics, with simple iterations consisting of basic phonetic sounds, while a complex variation might consist of a more fully-formed sentence.
Here is an overview of some of the tics you might expect to see within each category:
Simple Motor Tics
- Eye blinking,
- Shoulder rotation or elevation,
- Head jerking,
- Lip contractions,
- Closing of the eyes,
- Eyes rolling in the orbits,
- Torticollis (turning the neck to one side),
- Opening and closing of the mouth,
- Abdominal contractions, and/or
Stretching of arms and legs.
Complex Motor Tics
- Touching objects,
- Trunk bending or rotation,
- Socially inappropriate movements,
- Obscene gestures, or
- Imitation of other peoples’ gestures
Simple Vocal Tics
- Clearing of the throat
- Meaningless sounds or utterances.
Complex Vocal Tics
- Complex and loud sounds
- Phrases out of context
- Phrases with obscenities
- Repetition of other person’s phrases
It’s important to point out here that tics are not present throughout all parts of the day for those who struggle with Tourette’s. Although they might be frequent in the broader sense of the term, they’re not an ever-present. For example, they can often be suppressed during times when concentration is needed or when there is an outside distraction that is pulling attention away from the individual’s awareness of themselves. This is especially true of TV. Many people view this as the sufferer having control over their condition when, in reality, to actively suppress tics for a prolonged amount of time is extremely demanding.
In terms of addressing Tourette’s, there is nothing that will cure the condition outright that has yet been discovered. All treatments that are currently available are focused more on the management of the condition with there being two main avenues that can be explored. Which one you choose will be dependent on the severity of the symptoms presenting and your own personal view on the merits of each treatment type. Below are some of the options that you could look to explore:
Dopamine Inhibitors: Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap) help suppress tics. However, side effects can include weight gain. Tetrabenazine (Xenazine) is another possible option, but has been linked to depression.
Botulinum (Botox) injections: These have been known to help relieve motor tics in specific parts of the body, Mainly the face.
ADHD Medications: Drugs such as methylphenidate (Metadate CD, Ritalin & LA) as well as those containing dextroamphetamine (Adderall, XR & Dexedrine) have been known to increase attention span and concentration. However, in some instances, they can worsen symptoms.
Habit Reversal Therapy: This includes the cognitive behavioural approach for preventing lessening the frequency of tics. This includes monitoring your tics, identifying in what circumstances they occur most and the urges that come that bring them on.
Psychotherapy: For many people, tics and Tourette’s are part of a more complex condition such as ADHD, Depression or anxiety, which Tourette’s-like signs may be a symptom of themselves. Psychotherapy can help address some of the broader issues that might be at play.
Deep Brain Stimulation (DBS): In severe cases in which tics remain unchanged after traditional forms of treatment, DBS could be the solution. It is, however, quite invasive as it involves implanting an electrical device into the brain to help regulate tics, and is also still in the early stages of development.