What is Tourette Syndrome?

[Chemar]

Hi everyone :)

It has been suggested that it would be a really good idea to have a thread on each forum that explains the specific condition that we are here for.

So this thread is here for us to explain what Tourette Syndrome is.

I would greatly value input from everyone here, so please do add to the very basic description that I am going to provide.


Tourette Syndrome, aka TS, is named after a 19th century French physician Gilles de la Tourette, but was actually first documented by a Dr Itard in France in 1825

It is a neurological disorder that is characterised by involuntary tics, predominantly motor, but also vocal. The current diagnostic criterion for TS is that the patient must have displayed both motor and vocal tics for at least one year, with characteristic waxing and waning.

Tics can be simple (involving a single movement or vocalization) or complex (involving multiple movements or vocalizations)

Research is ongoing, but it is believed that the basal ganglia are the area of the brain most involved in TS, and that there is a hypersensitivity of the dopaminergic neurotransmitter system

TS is frequently accompanied by other neurological disorders like Attention Deficit Disorder(with and without Hyperactivity), Obsessive Compulsive Disorder, Sensory Integration Dysfunction etc

Genetic inheritance is a primary cause of TS, but other factors may also be responsible for the condition in some people. It seems to manifest more frequently in males than females and usually has an onset before the age of 18



so, there is Tourette Syndrome 101....
I have lots more to add, but I am really more interested in hearing other descriptions from you first.

[Lara]

Just a note about the information regarding Tourette's syndrome/tourette's syndrome as listed in the Medical Dictionary Link at the top of the page. The information listed is out of date and misleading. Efforts were made in the past by members of the TS community to correct their descriptions, but to no avail. It is important to be aware of these inaccuracies. Particularly those seeking information, consultation or diagnosis for Tourette's Syndrome.

1.

Definition of Tourette's syndrome from that particular Medical Dictionary...

http://cancerweb.ncl.ac.uk/cgi-bin/omd?Tourette's+syndrome
Tourette's syndrome

<syndrome> A neurologic disease of unknown cause that presents with multiple tics (uncontrolled behaviour), associated with snorting, sniffing and involuntary vocalisations. The explosive utterance of obscenities is common. Treatment is with haloperidol.

My comments...

TS is not a disease.


Coprolalia or explosive utterance of obscenities is not "common" as stated.


Treatment in this day and age with Haloperidol/Haldol is very uncommon.



Tourette's Syndrome: Minimizing Confusion (http://www.tourette-confusion.blogspot.com/)
Roger D. Freeman, M.D., F.R.C.P.(C.)
Departments of Psychiatry and Pediatrics
University of British Columbia
Vancouver
Former Member of TSA-USA Medical, Professional and Scientific Advisory Boards.
"The definition does not require coprolalia (uncontrollable use of socially unacceptable words or phrases), though media presentations emphasize it because it can be dramatic. The definition is simply a multiple, changing pattern of tics (not necessarily at the same time) for at least 12 months, including at least one noise-making tic. (There is no requirement for severity or impairment.) You can have TS and function normally."

Tourette Syndrome "Plus"-Treatment of Tics and Tourette's Syndrome (http://www.tourettesyndrome.net/tourette_treatment.htm)
"The diagnosis of TS does not mean that the person necessarily needs medication."
"In the U. S., the most frequently prescribed medications are clonidine hydrochloride (Catapres®) and guanfacine (Tenex®), two alpha 2-adrenergic agonists."

____________

2.
Definition of tourette's syndrome from the Medical Dictionary (note different definition from Tourette's to tourette's)...

http://cancerweb.ncl.ac.uk/cgi-bin/omd?tourette+syndrome
tourette syndrome

<syndrome> Both multiple motor and one or more vocal tics present with tics occurring many times a day, nearly daily, over a period of more than one year. The onset is before age 18 and the disturbance is not due to direct physiological effects of a substance or a general medical condition. The disturbance causes marked distress or significant impairment in social, occupational, or other important areas of functioning. (dsm-IV, 1994)

My comments...

The "marked distress" and "significent impairment" criterion stated above, known as Criterion C, was deleted in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)
(American Psychiatric Association, 2000)
.
DSM IV-TR - Tourette's Disorder (http://www.behavenet.com/capsules/disorders/touretteTR.htm)

J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 44:3, MARCH 2005
Roger D. Freeman, M.D., F.R.C.P.(C.)
Departments of Psychiatry and Pediatrics
University of British Columbia
Vancouver
"We will continue to debate and refine the Tourette’s criteria,
but the continuing confusion caused by the manual’s
discrepancies violates the stated purposes of the DSM: to
be ‘‘a helpful guide to clinical practice’’ and ‘‘to facilitate research
and improve communication among clinicians and researchers’’

[Chemar]

thanks for correcting that info Lara

the very words "treatment is with Haloperidol" makes me cringe, after what that drug did to my son 8 years ago:(

[solidsquid]

I hope to add more soon, but as just a quick trivia snippet:

The first possible documentation of a description of the primary symptomology of TS can be found in the Malleus Malefacarum, a treatise on witchcraft. A passage described a priest who was thought to be possessed by evil spirits:

…when he passed any church, and genuflected in honour of the Glorious Virgin, the devil made him thrust his tongue far out of his mouth; and when he was asked whether he could not restrain himself from doing this, he answered: “I cannot help myself at all, for so he uses all my limbs and organs, my neck, my tongue, and my lungs, whenever he pleases, causing me to speak or to cry out; and I hear the words as if they were spoken by myself, but I am altogether unable to restrain them; and when I try to engage in prayer he attacks me more violently, thrusting out my tongue.

References:

Kramer, H. and Sprenger, J. (1486/1971). The Malleus Maleficarum (Montague Summers, Trans.). Mineola: Dover Publications.

[Chemar]

yes, sadly many people with neurological illnesses were then, and are still today, misunderstood and falsely labeled

we actually had a relative suggest my son needed "deliverance" after he was hospitalized with a severe TS tic:(

but thankfully awareness and knowledge has come a long way and, although we still have a loooong way to go in educating people about TS, still, a lot of progress has been made.