Tourette syndrome, or shortly called TS, it is a neurological disorder discovered by French pioneer neurologist Dr. Geroges Gilles de la Tourette in 1885. TS is characterized by repetitive involuntary movements and vocalization also called tics.

The first signs of TS are noticed in childhood between the ages of 7 and 10 years. Even though Ts is an incurable condition, most patients experience the worst symptoms in their teens and they discover an improvement into adulthood. It affects all ethnic groups and is encountered in men three times more and in women.

The tics caused by Tourette are classified into two categories:

-         Simple motor tics like hand tremor, involuntary muscle contraction, rapid blinking, head and shoulder jerking

-         Simple vocalization like repetitive throat cleaning and sniffing

-         Complex motor tics like facial grimacing combined with head twists, jumping, bending and twisting

-         Complex vocalization like extensive  sniffing, grunting or even barking

The most dramatic tics involve self punching coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others).

Tics are more often worse with anxiety or certain physical experiences. Tics don’t disappear during sleep but are often diminished.

The causes of TS are currently unknown but it is thought to be triggered by abnormalities in the cortex and in the neurotransmitters in charge of communication between the nerve cells.

The diagnosis of TS is based on a 1 year evaluation time of the vocal and motor symptoms. The tests that need to be effectuated are magnetic resonance imaging, electroencephalogram and computerized tomography. TS is an inherited condition, so if there are any other cases in the family, they help to establish an accurate diagnosis.

Patients with TS experience additional neurobehavioral problems that include hyperactivity and impulsivity, ADHD (attention deficit hyperactivity disorder) and related problems with reading, writing, and counting; and obsessive-compulsive symptoms.

There is no known cure for TS but there are meds that can improve patient’s life. Neuroleptics like haloperidol or pimozide are the most c useful medications for tic suppression. The most common side effects of neuroleptics include sedation, cognitive dulling and weight gain.  Neurological side effects such as tremor, parkinsonian-like symptoms, and other involuntary movements are less common and are readily managed with dose reduction.  The risk of this side effect can be reduced by using lower doses of neuroleptics for shorter periods of time.

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