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Tourette Syndrome (TS) is a neurological or "neurochemical" disorder characterized by
tics -- involuntary, rapid, sudden m...
Individuals not only struggle with the condition itself, they must bear the double burden
of the stigma attached.

Two cat...
haloperidol (Haldol®), pimozide (Orap®), clonidine (Catapres®), clonazepam
(Rivotril®) and nitrazepam (Mogadon®). Stimulan...
That’s called Coprolalia and is NOT a defining characteristic of Tourettes. In fact, it only
affects 10-15% of Tourette su...
Hugging others
Raises arms above head

Tends to disrupt tests (shouts answers accidently)

That doesn’t cover the some of ...
remember reading somewhere, however, that the person needs to be 25+ to have it done
on them.

When Tourettes occurs, it d...
kinds of skill areas that can be affected. Many people with Tourette syndrome are
chronically disorganized.

There are a s...
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Tourettes

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Tourettes

  1. 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. 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. 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. 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. 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. 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. 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.

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