Tourette Syndrome
Tourette Syndrome was named for Georges Gilles de la Tourette, who first described the
syndrome in 1885. Although the disease was identified in 1885, today in 1996, there still
is a mystery surrounding Tourette Syndrome, its causes and possible cures. Tourette
Syndrome is a neurological disorder that researchers believe is caused by and abnormal
metabolism of the neurotransmitters dopamire and serotonin. It is genetically
transmitted from parent to child. There is a fifty percent chance of passing the gene on
from parent to child (Gaffy,Ottinger). Those most at risk are sons of mothers with
Tourette Syndrome. About three-quarters of Tourette Syndrome patients are male. Males
with the disorder have a ninety-nine percent chance of displaying symptoms. Females,
have a seventy percent chance of displaying symptoms. This ration of 3-4:1 for males and
females may be accounted for by referral bias. Also, there is a frequent number of
reported cases within the Mennonite religious isolate population in Canada
. The specific genetic transmission however, has not been established. Some researchers
believe that the mar is on an autosomal dominant trait. Some cases however are sporadic,
and there may not be a link to family history involved. These cases are mild however,
and not full blown. The onset of Tourette Syndrome must be before the age of fifteen, and
usually occurs after the age of two. The mean age onset of motor tics is seven. The
mean age onset for vocal tics is nine. In order for a person to be classified as having
Tourette Syndrome they must have both multiple motor tics and vocal tics. These tics
however do not have to occur everyday. In fact, affected individuals may rarely exhibit
all of the symptoms, or all of the tics. The vocal and motor tics must also occur within
the same year, for a person to be classified as having Tourette Syndrome. Symptoms can
disappear for weeks or months at a time. However if people afflicted with the syndrome
try and suppress their tics, they will reoccur with i
ncreased ferver. Tics increase as a result of tension or stress, and decrease with
relaxation or concentration on absorbing a task.
Tics are classified into two groups: complex and simple tics. Simple tics are
movements or vocalizations which are completely uncomprehendable and meaningless to those
not suffering from the disorder (Peiss). Complex tics are movements or vocalizations
which make use of more than one muscle group to appear to be meaningful (Peiss). Simple
motor tics are: eye blinking, head jerking, shoulder shrugging or facial grimacing.
Simple vocal tics are: throat clearing, coughing, snorting, baiting, yelping. Examples
of complex motor tics include: jumping, touching over people, and or things, smelling,
stomping loudly, making obscene gestures, hitting or biting oneself. Complex vocal tics
are any understandable words given out of context, and may including echoing and
repetition.
Other problems associated with Tourette Syndrome include Attention-Deficit Disorder,
Hyperactivity Disorder, disinhibition, obsessive compulsive disorder, dyslexia and other
various learning disabilities, and various sleep disorders. People with Tourette
Syndrome do tend to present more other Axis 1 disorders than the rest of the normal
population not afflicted with the syndrome. People with Tourette Syndrome are also
afflicted with obsessions of contamination, disease, sexual impulses, self harm, being
"just right", and death.
Sixty percent of those who are diagnosed as having Tourette Syndrome will also display
some type of learning disorder. Such disorders include: having difficulty organizing
work, having difficulty playing quietly, talking excessively, interrupting and intruding
on others, having a shorter attention span, losing necessary materials for school and
home, and engaging in physically dangerous activity, with no thought given to the
ramifications of their actions. Attention-Deficit/Hyperactivity Disorder is also found
in sixty percent of those with Tourette Syndrome. Those with ADHD are easily distracted,
has difficulty getting along in groups, shifts from activity to activity, often blurts
out answers before asked, and fidgets with hands, feet, or squirms in seat. Although
these symptoms may seem fairly similar it Tourette Syndrome, it is important to remember
that Tourette Syndrome is a genetically inherited disease. These other complexes are
merely brought on by the neurological imbalance which affects the b
rain of those afflicted.
Tourette Syndrome cannot be treated as a whole. Medications must be issued for the
different aspects of the disease. For example, Tics and movements are treated with
Neuoleptics, Clonidine and SErotonin Drugs, which are prozac-like. These drugs are very
good for treating muscle spasms as well as tremors. However the side effects may be
unpleasant. Therefore the patients under such drugs must be monitored for the liver and
heart. The Medical Treatment for OCD is augmenting dopamine agents (Orap) or Klonopin.
These drugs help curtail depression, but how genital-urinary side-effects. The ADHD
in Tourette Syndrome are treated with Ritalin because the tics may not increase if used
in reasonable dosages. Hyperactivity is also curtailed. The side effects of Ritalin are
urinary problems, skin changes, EEG monitor, and EKG monitor as well. The Tics may also
be controlled by visits to doctors office, talking to friends, and staying away from
social gatherings, and learning to deal with emotional trauma.
Help however is available for Tourette Syndrome. The goals of health professionals
concerning this disorder is to clarify reasons for school problems, and to develop and
individualized multimodality treatment program.
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