Tourette Syndrome – A Strange Disease?

Tourette Syndrome - A Strange Disease?

Tourette syndrome or Gilles de la Tourette syndrome is the result of a neurodevelopmental disorder. It is characterized by motor and vocal tics that can appear even in childhood. These tics are often accompanied by changes in behavior.

The French physician Georges Gilles de la Tourette described the syndrome in 1885, more than a hundred years, and v any people still considered it strange disease. It was later shown that between 0.3 and 1% of school children met the diagnostic criteria for this disorder.

Tourette syndrome – what is it?

The main feature of this syndrome is the chronic presence of at least two motor and one vocal tic, which manifest themselves before reaching adulthood . But what do we mean by a “tic”?

Tics are sounds, gestures, or otherwise involuntary and repetitive movements caused by the contraction of one or more muscles of the body – usually the face. These movements are convulsive, inappropriate, and exaggerated. Distraction or exertion of will may potentially reduce them.

A child shows a symptom of Tourette's syndrome.

Tourette syndrome affects all ethnic groups and occurs in both children and adults. Nevertheless, the average age of onset is only six years. It can also be observed that this syndrome occurs four times more frequently in men than in women.

Tourette syndrome tics

As we mentioned earlier, there are two types of tics manifest in Tourette syndrome : they are known as motor tics and vocal tics. A distinction is also made between simple and complex tics. The appearance of simple tics often precedes the appearance of more complex tics. Examples of simple tics include blinking, grimacing, shrugging, stretching the neck or abdominal muscles. Complex tics affect multiple muscle groups and consist of seemingly purposeful movements. Vocal tics are, for example, sniffling, grunting and clearing throat, or coughing for no reason.

The patient may feel a sense of increasing internal tension prior to the onset of these tics. The onset of the tic is then what ultimately releases that tension. These feelings of tension, also known as “premonitory impulses”, are very characteristic of tics and allow Tourette’s syndrome to be differentiated from other hyperkinetic movement disorders.

Patients usually consult their doctor because they want treatment for their tics. Some patients already present when they show only mild symptoms that often go unnoticed in everyday life. However, it is also possible that the syndrome is already so advanced that they make loud, high-energy noises or even cause injury to other people.

Diagnosis of Tourette’s Syndrome

Diagnosis of this syndrome is clinical and based on observation and the patient’s medical history. The diagnostic criteria for Tourette’s syndrome are as follows:

  • At least two motor tics and one vocal tic
  • Presence of tics for at least twelve months
  • First manifestation at the age of <18 years
  • Tics cannot be explained by substances (e.g. stimulants) or other diseases (e.g. Huntington’s disease)

It is not uncommon for patients to be officially diagnosed with Tourette’s syndrome after years of exhibiting its symptoms. There are many reasons for that. Relatives and doctors unfamiliar with Tourette’s syndrome may consider symptoms such as mild tics and even moderate tics to be irrelevant. You might think of them as part of a growth stage or as a result of some other disease. For example, some parents think that blinking is related to eye problems. Others may believe that the runny nose is caused by allergies in certain times of the year. In still others, the diagnosis of Tourette’s syndrome is rejected.

Some patients end up self-diagnosing after reading up on Tourette’s syndrome or their parents, relatives, or friends.

A man has raised his hand and is screaming.

What are the causes of Tourette’s syndrome?

Not much information is available on the cerebral and extracerebral processes underlying tics. Neurochemical examinations of the central nervous system of those affected indicate a dysfunction of the dopaminergic pathways within the corticostriatal-corticofrontal circuit. Neurological studies in patients with Tourette’s syndrome have also shown evidence of deficiencies in brain maturation. With this in mind, it has been found that neurons of the corpus striatum migrate to other areas.

It is also important to note that although there is a genetic predisposition, this alone cannot explain the disorder. On the other hand, data from epidemiological and laboratory studies have highlighted the importance of environmental factors. These factors relate to infections and autoimmune diseases, as well as prenatal and perinatal problems.

Tourette’s Syndrome on the big screen

Tourette’s syndrome has been shown to us on our TV screens and in cinemas several times:

  • In Tricks  (2003) , Nicholas Cage’s character suffers from this syndrome. This film tells the story of two little thieves who sell water filters.
  • The main character in the film Dirty Filthy Love   (2004; not dubbed) , interpreted by Martin Sheen, also suffers from this syndrome. This film tells the story of a man who breaks down on himself because of his Obsessive Compulsive Disorder and Tourette’s Syndrome.
  • The film Tics   (2008) is also about this syndrome. The main character is a teacher who cannot find a job because he suffers from this disease.

Because tics are not always debilitating, most people with Tourette’s syndrome do not need medication to keep their tics under control. However, there are effective medications available for people whose tics and other symptoms are affecting their daily lives more.

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