This document provides an overview of Tourette syndrome, including its characteristics, types, genetics, and management and treatment. Tourette syndrome is a neurological disorder characterized by involuntary vocal and motor tics. It most often begins in childhood and can range from mild to severe. While there is no cure, treatment aims to manage symptoms and may include psychotherapy, medication, and in some cases, surgery. Research into the genetics and neurobiology of Tourette syndrome continues in hopes of gaining further understanding and finding new treatments.

1. Ronan O’Brien

2. Overview
History
Types of Tourettes Syndrome
Characteristics
Genetics
Management & treatment
The Future

3.  Complex syndrome
 Movement disorder
 Neurological condition
 Neuro-psychatric condition
 Characterised by multiple motor tics and at least
one vocal
 Males affected 3 times more than females
 Broad spectrum of mild to severe involuntary and
chronic tics
 Tics usually start in childhood
 No cure

4. Previously considered by some to be
demonic possession
Identified as medical condition in
1885
Named after Dr. Gilles de La Tourette

5. Coprolalia
 Socially inappropriate words and phrases
Copropraxia
 Obscene gestures
Echolalia
 Repeating words of others
Palilalia
 Repeating own words

6. Video
Interview with someone with Tourette
syndrome..

7. Repeated movements/sounds
Premonitory urge/compulsion
Involve entire body or single muscle
Typically get better and worse over time
Often arise from heighted sensitivity to cues
from within the body or outside world
Unwanted sensory urges that besiege the
individuals conscious awareness

8. Simple
Isolated
Involve one
muscle group
Single or
repetitive
Eye blinking
Sniffing
Shoulder
shrugging

9. Complex
Coordinated
Several
muscle
groups
Sequential
Twirling
Phrases
Hitting
or biting

10.  “A feeling of pressure – a need that’s very hard to
describe, like something itches deep inside you –
but no one place you can describe; and the only
way you can relieve this need is by tics. It’s like
your brain itches, or your insides are being
tickled..”
 “The first one seems irresistible, calling for an
almost inevitable response.. the end of the tic is
the “feel” that is frequently accompanied by a
fleeting and incomplete sense of relief.”

11. Abnormal
metabolising of brain
neurotransmitters
Imaging techniques
indicate failure in
circuits connecting
the brain's cortex and
subcortex

12. Prevalence not well established but research
suggests about 1/100 in population
Several genes thought responsible
Abnormalities in SLITRK1 implicated
50% chance of passing on genes to children
Not everyone who has TS has the genetic form

13. Early treatment
 Tics can provoke ridicule and rejection
Psychotherapy
 Cognitive Behavioural Therapy
Deep Brain Stimulation surgery
Tranquilisers
 Counteract dopamine over-activity by blocking
dopamine receptors
 Botulinum toxin (BTX) - injected into the muscles
Antidepressants
 Enhance serotonin's neurotransmission activities

14. Allergies / sensitivies
 Food, chemical and environmental allergens
 Allergens may trigger a release of serotonin which
causes decreased blood flow in the basal ganglia
Nicotine and cannabis to inhibit the release of
dopamine.
Magnesium deficiency
Feldenkrais method / osteopathy / massage
Meditation / relaxation techniques

15. The Future
Tourettes has come out of the dark ages
Increase in multi-displinary research
 Neuroimmunology
 Neurophysiology
 Epidemiology
Neuropathology
 Post-mortem brains from TS patients
New technologies / medication
 Neuro-imaging techniques

16. The End
Thank you 