Tourette Syndrome Overview

Tourette Syndrome is a medical condition of the nervous system manifesting in childhood and characterized by tics, which are uncontrollable, rapid and repetitive movements or sounds.

Boys are 3-4 times more susceptible than girls. The age of onset for symptoms occurs between ages 2-12, with the average age of 7. The symptoms do decrease once the individual reaches age 20. While there is no cure, symptoms can be controlled and there is a normal life span associated with the condition.

Prior to the outward display of tics, a child may feel an uncomfortable sensation like an itch, tension or tingling. This is known as a premonitory urge.

Tics can occur even in sleep and intensify during illness, stress, anxiety or when someone is tired or excited. The tics, which intensify during the teens, do improve after age 20. They also improve or lessen when the child is concentrating on a specific activity such as homework.

Generally, tics occur in alternating periods with tic-free behavior lasting anywhere from several seconds to a few hours.

Tics are sorted into different classifications as follows:

  • Simple Motor Tics - sudden, repetitive motions of short term duration, linked with few muscle groups
    • Blinking or darting of eyes
    • Facial grimacing
    • Head jerking
    • Tongue protrusion
    • Shrugging of shoulder
    • Finger flexing
  • Complex Motor Tics - coordinated motion patterns associated with several muscle groups
    • Obscene gestures (copropraxia)
    • Touching other people or constant touching of nose
    • Smelling objects
    • Arm flapping
    • Hopping
    • Squatting
    • Twirling
  • Simple Vocal Tics - involves sounds and lasts less than a few hundred milliseconds
    • Yelling
    • Barking
    • Throat clearing
    • Hiccupping
  • Complex Vocal Tics - involves full speech and language
    • Repeating words and phrases of others (echolalia)
    • Repeating one’s own words (palilalia)
    • Voicing obscene or vulgar words
    • Manifesting a variety of voice tones

There are two additional types of tics, which occur much less commonly:

  • Phantom Tics - perceives a sensation in others which is relieved only by touching or scratching the individual or object
  • Sensory Tics - repetitive uncomfortable sensations in the eyes, throat or shoulders. Can also feel temperature or pressure changes or a tickling

 

Written by Barbara Hales, MD

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