Tourette's Syndrome (TS)

Tourette's Syndrome (TS)

Introduction

It is a neurological disease developing at the start of young age having hereditary factors associated with it. Main characteristics of the disease are frequent, identical, involuntary movements and vocalizations known as tics which the patient manifests for more than one year.

For the first time the disorder was identified by a French neurologist, Dr. Georges Gilles de la Tourette in 1885.

Discussion

Symptoms

Initial symptoms of TS usually appear in early childhood between the ages of 3 and 9 years. TS has been reported in all racial groups and males are about three to four times more prone to develop TS as compared to females. More than 200,000 Americans are the victims of this disease with intense symptoms and circa 1% manifest symptoms of low intensity like prolonged motor or vocal involuntary movements. These diverse symptoms in a chronic case vary in all patients and their features and intensity may be present during life time (Singer, 2005). Studies have proved that most sufferers tend to have worst symptoms of disease like tics in their early childhood. Improvement in patient's condition usually occurs in emerging adulthood.

Involuntary movements or motor tics of TS have been categorized into two types; simple and complex. Simple motor tics generally occur suddenly having short duration. These are recurring movements and only a few muscles get affected. Common examples of simple tics include eye blinking and other eye movements, facial grimacing, shrugging of shoulder and jerking movements of head and shoulder. Recurring throat-cleaning, sniffing, snorting, barking and grunting sounds are the usual examples of simple vocalization tics. On the other hand several muscle groups get involved in complex motor tics which are generally discrete, synchronized and guided movements. Facial grimacing along with a head twist and a shoulder shrug is one of the examples of complex motor tics. Sniffing, hopping, jumping, bending and twisting are generally other examples of complex motor tics but these get manifested purposefully. Use of words and phrases are the examples of complex vocal tics. Coprolalia, echolalia, echopraxia and copropraxia are examples of most disabling tics. However, coprolalia is only seen in few patients with TS. In some cases an urge or sensation develops in the affected muscle group before the manifestation of tics which is called a premonitory urge.

As seen in many individuals, tics get exaggerated with excitement and anxiety and follow a normal course during composed and focused actions. Tics can also be triggered with certain physical experiences. Substantial reduction in intensity of tics has been reported during sleep but movements do not disappear altogether.

Tics in TS vary from person to person with regard to type, frequency, location and intensity. Usually the initial symptoms appear in the head and neck region which subsequently involves muscles of the trunk and extremities with the passage of time. Generally motor tics appear before the manifestation of vocal tics and as a rule simple tics are followed by complex tics in majority of the patients.

Tics of TS are involuntary movements ...