T OURETTE ’ S S YNDROME By: Kathryn Wrightsman

O VERVIEW OF T OURETTE S YNDROME Gilles de la Tourette Syndrome (Tourette Syndrome or TS) is a neurological disorder that becomes noticeable in early childhood. Tourette Syndrome is characterized by persistent motor and vocal tics lasting over one year. Tics are involuntary movements of the face, arms, and legs. Vocal tics usually occur with the motor tics and include, grunting, barking, and shouting. TS cases range from severe to mild, but most cases fall into the mild category. (Tourette’s Syndrome Association)

T HE C OURSE OF T OURETTE ’ S S YNDROME

H ISTORY The first presentation of Tourette’s Syndrome is said to be in a 1489 book, “Malleus Maleficarium”. The book describes a priest whose frequent tics were blamed on the devil. Jean Marc Gaspard Itard reported the first case of Tourette’s Syndrome in After this diagnosis, Georges Albet Edourard Brutus Gilles de la Tourette, a French physician and neurologist, was assigned to study patients. In 1885 Gilles de la Tourette published his study, identifying these symptoms as a new disease, later being names Tourette’s Syndrome.

D IAGNOSIS No substantial diagnosis can be done using only tics. Sometimes tics come and go, but if they regulary appear throughout a one year period, then a diagnosis of TS among other diseases. (MedicineNet) Blood tests do not help diagnose Tourette’s Syndrome, but neurological tests can be done. (MedicineNet) Tourette’s Syndrome is most commonly misdiagnosed and mistaken for severve cases of ADHD and OCD. (Tourette’s Syndrome Association)

T RANSMISSION Studies show that there is a 8.7 percent chance of directly inheriting the Tourette’s gene from a parent. There is up to a 2 percent chance of inheriting Tourette’s from another relative. Analysises of pedigrees have supported transmission though an incompletely penetrant autosomal dominant gene if the phenotype is classified as TS only, not TS or CT or OCD. Many cases of TS have also been linked to chromosomal abnormalitites, including deletion. (National Institute of Neurological Disorders and Stroke)

S IGNS AND S YMPTOMS Signs- Verbal and Motor tics that persist for more than a year. Verbal tics are screaming, barking, moaning, grunting, and sniffing. Though heftily portrayed in the media, the use of profane language is rare. Syptoms- Tourette’s Syndrome has few side effects that are only known to the patient. The patient is aware that they are having a tic, contrary to some beliefs. (Tourette’s Syndrome Association)

E XAMPLE OF A TS E VALUATION

T REATMENT There is no cure for Tourette’s and no universal medication that works for all individuals who have TS. The most successful classes of medication for TS are typical and atypical neuroleptics, antihypertensive agents, and some stimulants. Tics are most commonly treated with antpsychotics which work by blocking dopamine receptors. Behavioral treatments include Habit Reversal Training, relaxation, and hypnosis and are considered more positive approaches to TS treatment. Procedures involving Nicotine and Deep Brain Stimulation have been tried, but are still considered experimental in the treatment of TS. (Tourette’s Syndrome Association)

R EFRENCE Tourette Syndrome Association. (2010). What is Tourette Syndrome? Web. Retrieved May 2010, from Mayo Foundation for Medical Education and Research. (2010). Diagnosis. Web. Retrieved May 2010, from syndrome/diagnosis.html MedicineNet. (2010). Tourette Syndrome. Web. Retrieved May 2010, from tm Health Grades Inc. (2010). Symptoms of Tourette Syndrome. Wed. Retrieved May 2010, from mptoms.htm#symptom_list syndrome/diagnosis.html tm mptoms.htm#symptom_list