MEDICAL SURFARI: TOURETTE'S SYNDROME: WHAT IS IT?

In medieval times, sufferers from this neurological disorder were thought to be possessed by the devil. Dr. Gilles de la Tourette in 1884 first described this syndrome. For centuries it's sufferers were treated as if they were possessed and some were thought to be witches and were tortured.

Tourette's syndrome is a type of nervous tic (habit, spasm) that results in brief, purposeless, semi-involuntary or involuntary movement or vocalizations that occur repeatedly in the same way. These movements are stereotyped and repetitive but not rhythmic.

Simple tics often begin as nervous mannerisms in childhood and may later disappear spontaneously. Complex tics often resemble fragments of normal behavior. It is important to point out that the myoclonus, a brief lightening-like contraction of a muscle or group of muscles, is not a tic. The cause of this syndrome is still not well understood but may be due to an imbalance in the neurotransmitters (signaling chemicals) in the brain.

These tics may be controlled, but persistent tics become automatic. The face, shoulders or arms are most often affected. The most common nervous tics include twitching of the corner of the mouth or eye blinking, grimacing, shoulder shrugging or arm movements. The most severe form of the syndrome includes bazaar noise-making, uncontrollable swearing and troublesome sexual and aggressive impulses.

There seems to be a family clustering of this syndrome because it has been observed in other family members in one-third of patients with the syndrome. Tourette's syndrome usually begins in childhood and gradually worsens in extent and severity. This syndrome is three times more prevalent in males.

During the teenage years, uncontrollable grunting, barking, sniffing and shouting may develop. The course of this disorder is unpredictable, but in many cases it stabilizes by adulthood. In some patients the syndrome subsides and long remissions may occur.

Trying to stop the shouting or twitching of Tourette's without treatment is about as effective as trying to stop a sneeze. Neuroleptic medications are most commonly used to treat this disorder and these may be prescribed independently or in combination with other medications to prevent some of the side effects of neuroleptic medications. Research is being conducted to achieve a better understanding of the neurotransmitters involved in this complex syndrome.

If you suspect that you or someone you know may have this syndrome, see your physician for a proper neurological examination and to become informed about support groups and other resources for Tourette's syndrome.

World Wide Web

Tourette syndrome association

www.mentalhealth.com/book/p40-gtor.html

Via this web site, you can access the "guide to the Diagnosis and Treatment of Tourette Syndrome", which is a very comprehensive booklet for health professionals who wish to become more knowledgeable about tourette syndrome.

Tics and Tourette's

http://pediatricneurology.com/tics.htm

The Pediatric Neurological Associates in conjunction with the National Institute of Neurological disorders and Stroke provides this information on Tourette Syndrome.

Tourette's syndrome/Obsessive Compulsive Disorder Specialty Clinic and Research Group

http://info.med.yale.edu/chldstdy/tsocd/

If you are interested in accessing the Yale Child Study Center, which has several ongoing research projects related to Tourette Syndrome, this site will be helpful to you.