1. Tourette Syndrome (TS) is a neurological or "neurochemical" disorder characterized by
tics -- involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the
same way.
The cause has not been established, although current research presents considerable
evidence that the disorder stems from the abnormal metabolism of at least one brain
chemical (neurotransmitter) called dopamine. Very likely other neurotransmitters, such
as serotonin, are also involved.
In 1825 the first case of TS was reported in medical literature by Dr. Itard. It was a
description of the Marquise de Dampierre, a noblewoman whose symptoms included
involuntary tics of many parts of her body and various vocalizations including echolalia
[repetition or echoing of verbal utterances] and coprolalia [involuntary swearing or the
involuntary utterance of obscene words or socially inappropriate & derogatory remarks].
She lived to the age of 86 and was again described in 1883 by Dr. Georges Gilles de la
Tourette, the French neurologist for whom the disorder was named. Samuel Johnson, the
lexicographer and André Malraux, the French author, are among the famous people who
are thought to have had TS.
What is TS - Frequency/Ratio of TS
Since many people with TS have yet to be diagnosed, there are no absolute figures.
Recent genetic studies suggest that the figure may be one in one hundred when those with
chronic and transient tics are included in the count.
The most common first symptom is a facial tic, such as rapidly blinking eyes or twitches
of the mouth. However, involuntary sounds, such as throat clearing and sniffing, or tics of
the limbs may be the initial signs. For some, the disorder begins abruptly with multiple
symptoms of movements and sounds.
The symptoms include;
1. Both multiple motor and one or more vocal tics present at some time during the
illness although not necessarily in the same way;
2. The occurrence of tics many times a day (usually in bouts) nearly every day or
intermittently throughout a span of more than one year;
3. The periodic change in the number, frequency, type and location of the tics,
disappear for weeks or months at a time; and
4. Onset before the age of 18.
The term "involuntary" used to describe TS tics is a source of confusion since it is known
that most people with TS do have some control over the symptoms. What is recognized is
that the control which can be exerted from seconds to hours at a time, may merely
postpone more severe outbursts of symptoms. Tics are experienced as irresistible as the
urge to sneeze and must eventually be expressed. People with TS often seek a secluded
spot to release their symptoms after delaying them in school or at work. Typically, tics
increase as a result of tension or stress (but are not caused by stress) and decrease with
relaxation or concentration on an absorbing task.

2. Individuals not only struggle with the condition itself, they must bear the double burden
of the stigma attached.
Two categories of TS tics and some common examples are:
Simple:
Motor - Eye blinking, head jerking, shoulder shrugging and facial grimacing;
Vocal - Throat clearing, yelping and other noises, sniffing and tongue clicking.
Complex:
Motor - Jumping, touching other people or things, smelling, twirling about and,
although very rare, self-injurious actions including hitting or biting oneself;
Vocal - Uttering ordinary words or phrases out of context, echolalia (repeating a
sound, word or phrase just heard) and in rare cases, coprolalia (vocalizing socially
unacceptable words). The range of tics or tic-like symptoms that can be seen in TS is
enormous. The complexity of some symptoms often confuses family members, friends,
teachers and employers who may find it hard to believe that the actions or vocal
utterances are "involuntary".
A diagnosis is made by observing symptoms and by evaluating the history of their onset.
No blood analysis, x-ray or other type of medical test exists to identify TS. However, a
doctor may wish to order an EEG [Electroencephalogram], CAT [Computerized Axial
Tomography] scan or certain blood tests to rule out other ailments that could rarely be
confused with TS.
Check Lists
The following “check-lists” can be utilized in the diagnosis process. Recording of
symptoms over a period of time is required as part of the diagnosis process.
Check List – TIC Symptoms (Motor) 39 kb
Check List – ADHD Symptoms 30 kb
Check List – OCD Symptoms 39 kb
At this point in time, there is no cure for TS. Remission can occur at any time. Present
data suggests that the tic symptoms tend to stabilize and become less severe in adult life.
Those diagnosed with TS can anticipate a normal life span.
The majority of people with TS are not significantly disabled by their tics or behavioural
symptoms and therefore do not require medication. However, there are medications to
help control symptoms when they interfere with functioning. The drugs include

3. haloperidol (Haldol®), pimozide (Orap®), clonidine (Catapres®), clonazepam
(Rivotril®) and nitrazepam (Mogadon®). Stimulants such as methylphenidate (Ritalin®)
and dextroamphetamine (Dexedrine®), that are prescribed for hyperactivity may
temporarily increase tics and should be used cautiously. Obsessive compulsive symptoms
may be controlled with fluoxetine (Prozax®), clomipramine (Anafranil®) and other
similar medications.
The dosage necessary to achieve maximum control of symptoms varies for each patient
and must be gauged carefully by a doctor. The medicine is administered in small doses
with gradual increases to the point where there is a maximum alleviation of symptoms
with minimal side effects. Some of the undesirable reactions to medications are fatigue,
motor restlessness, weight gain and social withdrawal, most of which can be reduced
with specific medications. Side effects such as depression and cognitive impairment can
sometimes be alleviated with dosage reduction or a change of medication.
Other types of therapy may also be helpful. Sometimes psychotherapy can assist a person
with TS and help his/her family cope with the psycho-social problems associated with
TS. Some behavioural therapies can teach the substitution of one tic with another that is
more acceptable. The use of relaxation techniques and/or biofeedback may help during
prolonged periods of high stress.
Genetic studies indicate tic disorders, including TS, are inherited as a dominant gene(s)
that may produce varying symptoms in different family members. A person with TS has
about a 50% chance of passing the gene(s) to one of his/her children. However, the
gene(s) may express as TS, as a milder tic disorder, or as obsessive compulsive
symptoms with no tics at all. It is known that a higher than usual incidence of milder tic
disorders and obsessive compulsive behaviours are more common in the families of TS
patients.
The sex of the child also influences the expression of the gene(s). The chance that the
child of a person with TS will have the disorder is at least three times higher for a son
than for a daughter. Yet only a minority of the children who inherit the gene(s) will have
symptoms severe enough to ever require medical attention. In some cases, TS may not be
inherited; these cases are identified as "sporadic" TS because a genetic link cannot be
found.
Hello there. My name is Kimberly B. I’m 15 years old and I have Tourette Syndrome.
This is to help people understand what Tourettes is.
First of all, dispite popular belief, Tourettes is NOT just people shouting obscene words.

4. That’s called Coprolalia and is NOT a defining characteristic of Tourettes. In fact, it only
affects 10-15% of Tourette sufferers. The media just thinks it’s funny so that’s all they
show of Tourettes.
Here is a list of my tics so far. I have A LOT of them, as you will see.
This isn’t a complete list of what people with tourettes do, this is just what I do.
Squints eyes
Slaps face
Punches face
Claps hands
Hits self
Acts like a chicken
Shouts and screams
Repeats things she sees
Repeats things she hears
Shakes and jerks head
Sniffs
Rolls eyes
Scary arms (raising arms above head like scaring someone)
Stomp feet
Snaps fingers
Growls and barks
Snorts and grunts
Claws at air
Finger and hand tapping
Shoulder shrugs
Arm movements
Finger and hand movements
Touching others
Hitting others
Nose wrinkling
Meowing, hissing and purring
Stuttering
Howl like wolf
Click
Repeats others
Repeats self
Scratches at self
Biting self
Waving
Pets people
Sounds like catching breath
Sighs
Swears (not often)

5. Hugging others
Raises arms above head
Tends to disrupt tests (shouts answers accidently)
That doesn’t cover the some of the ones I’ve developed since then.
We can’t control the things we do. It’s caused by too much of a chemical called
dopamine in our brains.
Tourettes, in my opinion, shouldn’t be characterized by the tics but rather from the urge
to tic. For me, the urge is a tension in my spine that grows until I let the tic out. The more
it grows, the more tics I need to let out. That urge varies from person to person.
There are quite a few types of tourettes. Some of them include:
Echopraxia – Copies others movements
Echolalia – Copies others sounds
Coprolalia – Shouts obscene words
Copropraxia – Obscene gestures
Palilalia – Copies own words
If tics are bad enough, they can affect many things including fine motor skills and
balance, as well as concentration.
It’s possible for the Touretter (What I call those who have Tourettes) to hold in tics.
However, that urge keeps growing and growing. Think of it like a scratch on your foot. If
you ignore it, it becomes all you can think about until you scratch it. Well, it’s the same
with Tourettes.
Another thing is: if the Touretter holds the tics in, the tics get worse when they’re finally
let out.
There’s no cure for tourettes. However, there are medications to help treat the tics. Some
of these are:
Resperidal
Orap
Tenex
Haldol
There’s also brain surgery that can be performed if the case is serious enough. I

6. remember reading somewhere, however, that the person needs to be 25+ to have it done
on them.
When Tourettes occurs, it doesn’t usually occur alone. There are many co morbid
conditions that go along with it. Some of these are:
ADD
Anxiety disorders
Asbergers
OCD
Some people with tourettes have trouble with writing things. They may refuse to write
because of tics that interfere with their writing.
Many students with TS have something called dysgraphia, which is the inability to get
thoughts from the brain to paper for a wide variety of reasons. This can produce messy
handwriting.
A student may have difficulties understanding a homework assignment, be inconsistent in
copying down assignments, struggle to begin or complete assignments, fail due to
missing assignments, not turn in completed homework, etc. This is an area of difficulty
for the majority of students with TS particularly as they get into the higher grades.
The phenomenon known as dysinhibition is characterized by difficulty consistently
inhibiting thoughts and/or actions. Inappropriate statements or behaviors very frequently
result from the student’s inability to consistently apply “mental brakes”. Dysinhibition
means that a Touretter cannot stop themselves consistently from expressing behaviors,
thoughts, or displaying actions that someone else may be able to control. Such behaviors
might be displayed as excessive silliness, being sassy, free-associative comments,
emotional outbursts, contextual swearing, blurting out, inappropriate comments explosive
anger and oppositional defiance.
Picture a sign that says, “Don’t Touch, Wet Paint”. For many of us with difficulties
inhibiting, the sign is an invitation to touch the paint. We must fight the urge to do so if
we are to obey the sign and the norms of society. We must inhibit the very behavior that
has been suggested to us by the sign.
Inhibiting behaviors is challenging for all children but it presents a far greater challenge
for students with TS due to their impulsivity and inconsistent ability to apply their mental
brakes. This is caused by the chemical imbalance in our brains, and is not purposeful
disobedience.
Executive function involves the skills necessary to succeed in school and in life. A person
with executive deficits can have extraordinary talents and abilities, but they do not
possess the organizational capacities necessary to demonstrate these abilities in a manner
that is useful and productive. Time management and problem solving are examples of the

7. kinds of skill areas that can be affected. Many people with Tourette syndrome are
chronically disorganized.
There are a small percentage of children with TS who have outbursts of uncontrollable
anger often referred to as “rage” or “meltdowns”. Generally, but not always, this is more
likely to be displayed in the home setting. This is neither the fault of the child nor the
parents. Many parents blame themselves and are also blamed by professionals, friends
and family.