In January 1885, Dr Guilles de la Tourette published his landmark research about a rare movement disorder he called “maladie des tics”. His studies eventually became the basis for what now is commonly known as Tourette’s Syndrome.
What is it?
Also known as Gilles de la Tourette syndrome or Tourette’s disorder, this condition has a childhood-onset and is characterized by the presence of tics (several motor and at least 1 vocal) lasting at least 1 year.
Motor and verbal tics can appear at a wide range of intensities, some can be so mild that treatment is not even required while other cases are so severe that make difficult having a normal life.
Motor tics can manifest anywhere in the body but facial tics are the most frequent type. A small percentage of patients develop an interesting symptom called “echophenomena” which causes an individual to mimic other people’s movements involuntarily.
At least 1 vocal tic needs to be present to diagnose Tourette’s. Among the different vocals tics that can be present, one rare example includes “coprolalia” (saying profanities involuntarily). Unfortunately this is the one symptom the majority of the population knows and is usually not present in most patients.
The symptoms we already mentioned are the most essential, however, people with Tourette’s sometimes also experience: Anxiety, depression, oppositional defiant disorder and other behavioral or personality disorders.
How Common it is?
There is no absolute consensus about its epidemiology, however, the scientific and medical communities agree in that from 0,5% to 1% of the general population suffers from this condition.
Interestingly, Tourette’s is 3 to 4 times more common in males than females, this ratio seems to be almost constant worldwide.
How it Develops?
There seems to be a genetic component to this disorder. Studies confirm that people with a family history of Tourette’s are much more likely to suffer from it than people without it but at the moment no gene or group of genes has been identified as a key player in the development of Tourette’s syndrome.
Almost all cases appear at a young age, normally around 4 to 6 years old. Symptoms get progressively more intense as the child gets older usually reaching a peak at ages 10 to 12. Normally there is significant improvement during adolescence, symptoms can even disappear completely. Of all Tourette’s cases, only 15% of them persist until adulthood. These are always the most severe cases.
How is it Treated?
There is no cure. Treatment is actually contraindicated for very mild cases, these almost certainly will improve significantly without any special intervention and won’t affect the life of the individual in any meaningful way. As symptoms manifest in more severe ways, more direct and/or aggressive treatments are recommended. In order, the first option would be “supportive therapy”, followed by “behavioral therapy”, then “psychopharmacological treatment” and then “deep brain stimulation”.
Supportive therapy: It involves a therapist actively trying to help the patient to deal with his/her emotional problems by doing things like: comforting, advising, encouraging, reassuring, and listening, attentively and sympathetically.
Behavioral therapy: This is a broad term for different strategies used to identify and change problematic or unhealthy behaviors.
Psychopharmacological treatment: This approach uses psychoactive drugs and psychotherapy to alleviate anxiety and other disorders. For this treatment, the most commonly used drugs include: clonidine, guanfacine, risperidone, aripiprazole, tetrabenazine, pimozide, haloperidol and fluphenazine. None of these drugs can be taken lightly, they need to be recommended by an authorized healthcare professional since some of them can have very serious side effects.
Deep brain stimulation: This is the most aggressive method. Is usually reserved for adults with very severe symptoms. It involves a neurosurgical procedure in which parts of the brain are artificially stimulated with electricity. So far, experts seem to agree in that it works, however there is some controversy around this particular approach.
Recently, some unconventional treatment alternatives have been getting more attention for their capacity to help patients. One is an injection of botulinum neurotoxin and the other is the use of cannabis, which some authors say help reduce tics.
In this health blog we strive to provide as much useful information as possible, please let us know if you have any additional questions about this condition or you may also book an appointment for a doctor for consultation.