Tourette Syndrome: Causes, Symptoms, Diagnosis And Treatment
He Tourette syndrome It is a neurological disorder that causes the affected person to perform movements and sounds involuntarily and without a specific purpose.
These movements are repeated intermittently and tend to increase in stressful situations. It is usually considered a particularly severe and chronic form of multiple tics.
In this article we will see what Tourette syndrome is and how it affects people who develop it.
The symptoms that appear in the early stages of the development of Tourette syndrome begin between eight and eleven years of age, and their intensity is highly variable. The affected person may suffer periods of constant and frequent tics, and others in which their presence becomes practically non-existent. Boys are three to four times more likely to have Tourette syndrome than girls (1).
Tics can be classified as simple or complex tics:
Thus, Tourette syndrome is characterized by tics and problems inhibiting certain brief behaviors, which are expressed in a matter of seconds or fractions of a second.
Causes
The causes of Tourette syndrome They are still unknown and there is no scientific consensus on the matter. Some hypotheses suggest that its origin may be linked to affects in some brain regions and alterations in chemical substances (dopamine, norepinephrine and serotonin) that provide interneuronal communication.
Yes, it has been scientifically proven that Tourette syndrome is a hereditary disease and that an affected person has a 50% chance of transmitting the syndrome to their child. This gives clues about the role played by differences at the brain level with respect to the rest of the population.
However, the fact that a genetic predisposition is inherited does not mean that the child will suffer all the symptoms associated with the disorder, but rather that they will statistically have a greater chance of developing it compared to the rest of the population. It is possible to have certain gene variants that are never expressed, or that are expressed in combination with other genes and do not generate noticeable symptoms.
Typically, it has been observed that Children of people with Tourette syndrome may present some minor ticssome obsessive-compulsive behaviors, symptoms associated with attention deficit (without the presence of tics), or even a total absence of symptoms. This indicates that Tourette syndrome could present in a very varied spectrum of intensities, and that it does not exist as a closed category of equal severity in all people.
On the other hand, it is assumed that the most characteristic syndromes of Tourette syndrome are due to a failure in impulse regulation due to dysfunctions in the frontal lobes, responsible for a good part of the executive functions and the task of dampening the desire to perform actions in the moment.
Symptoms
Tourette syndrome It appears during some time in the first two decades of life, and in the same family unit there may be great variability in the presence of associated symptoms.. Usually, the first expression of the syndrome is usually a facial tic, and it is common for each affected person to present their own limited repertoire of tics, always repeating the same ones.
Over time, people with Tourette syndrome develop more motor tics of a variable nature. They include the blinking or tics of the facial muscles, the emission of guttural sounds, the sudden intake of air, kicking, shaking of the neck and head, etc. It is unknown if the appearance of complex tics is a cause of the previous appearance of simple tics, or if both phenomena are the result of an alteration that causes them in parallel.
Patients also express uncomfortable sensations in some parts of the body, such as itching, pressure, tingling, itching… These types of tics are called sensitive tics.
Verbal tics are less common than popularly believed. Only 10% of patients present echolalia (repeat what you hear) or coprolalia (involuntary emission of swear words or phrases). Some patients also express tics such as spitting and/or copromimia (offensive gestures).
The recurrence and intensity of tics can get worse or improve throughout the day, and can vary over time. The pathology tends to improve during and after adolescence, when the worst stage of Tourette syndrome is experienced, often being related to behavioral disorders. In this way, the frequency of significant tics and coprolalia (if it exists) is usually reduced when moving from adolescence to adulthood.
How are people affected by this syndrome?
People affected by Tourette syndrome They have normal intelligencealthough they may have added learning difficulties during childhood and adolescence, as a result of tics and associated behavioral and social pathologies. These pathologies are usually obsessive-compulsive disorder or attention deficit hyperactivity disorder (ADHD). It is also common for them to present conduct disorders (social isolation, impulsiveness, aggressiveness) and sleep.
Impulsivity problems usually also lead to depression and anxiety, but these are not part of the neurobiology of the syndrome itself, but rather are part of the consequences of its way of interacting with the environment and with others.
Sometimes, patients can manage to inhibit the tics for a period of time, but eventually they reappear in a more pronounced form, as if it were a way to compensate for the inhibition. Thus, it seems desirable that people around the patient be understanding and behave naturally in the presence of tics.
Some affected people present very mild symptoms, which do not require any treatment, and it is even common for their symptoms to disappear over time.
Treatment
No specific treatment is required for tics, except in cases of extreme severity or those that result in muscle pain or disorders in school and social adaptation. In these types of cases, they are usually straightr neuroleptic drugs to reduce the intensity and frequency of tics., although always under medical indication and under his supervision.
As far as psychological therapy is concerned, it is effective to treat disorders related to Tourette syndrome, such as stress, depression or anxiety, learning and behavioral problems, and the social and emotional consequences caused by the syndrome.
If the syndrome is accompanied by obsessive-compulsive disorder or ADHD, it will be advisable, apart from the therapies already explained, to appropriately treat these alterations that can negatively affect the person’s quality of life.
Three real cases
What is it like to live with Tourette syndrome? Several people with a notable professional career bring us closer to this neurological syndrome.
1. Mahmoud Abdul-Rauf, an NBA player
Can you suffer from Tourette’s and be successful in life? The case of Mahmoud Abdul-Rauf (whose birth name was Chris Jackson) is paradigmatic. We invite you to know his life in this article from the Spanish newspaper The Information.
2. Super Taldo: a Chilean boy with tics and coprolalia
An extreme case of Tourette Syndrome is the one he suffered from Agustin Arenasnicknamed “Super Taldo”, a Chilean boy who became well known thanks to a journalistic report on Chilean television. You can learn his story by entering this link.
Finally: an in-depth documentary about this condition
A documentary made by Xplora channel discovered the case of a 20-year-old boy who was diagnosed at the age of eight. In this brief excerpt from the report, the affected person tells us what it is like to live a day with constant tics. We offer it to you below.
