Tourette's syndrome is an inherited neurobiological condition consisting of repeated, involuntary movements and uncontrollable sounds called tics. Sometimes the vocal sounds can consist of inappropriate words or sentences. Here you read about what it is like to have Tourette.

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The article is based on an article from the Norwegian Tourette Association. They write:

Tourette's syndrome is named after the French neurologist Gilles de la Tourette, who was the first to describe the condition in 1885, and his description is about as we know the condition today.

 

Symptoms

The prominent symptoms are varied, involuntary movements and uncontrolled sounds called tics. Tics are repetitive, stereotypical, pointless and sudden movements and sounds.

Symptoms usually begin at the age of 2 - 18 years, most often at the age of seven hills. The first symptoms are most often tics on the face, such as excessive blinking, twitching and grimaces. They move to the neck, shoulders and upper body. Twitching in an arm or leg is typical. 

The vocal tics come a little later. In the beginning, they are often "normal", sniffing and raking, but can develop into other sounds and exclamations.

It is typical that one symptom is replaced by another, and that the symptoms increase and decrease in strength over a certain period. The tics can be briefly suppressed. They are therefore often more powerful at home than at school. Symptoms increase in stressful situations.  

 

Frequency and incidence

Tics for shorter periods, weeks to months, are common in children, especially at the age of seven to eleven years. Most will be transient tics conditions. By transient tics is meant motor and / or vocal tics that persist for at least four weeks, but no longer than 12 consecutive months.

It is assumed that the incidence of TS is about 0,5-1,5%. Four times as many boys as girls get TS. 


What are Tics?

Tics are defined as repeated, rapid, sudden, unexpected, purposeless, arrhythmic, and involuntary movements. Involuntary movements or contractions in muscles are called motor tics, and involuntary sounds are called vocal tics. In multiple tics, tics occur asynchronously in several body areas and with varying localization. The tics can act as single tics or composed of many different tics at the same time. They can vary in frequency and intensity.

 

Tics

 

  1. can be temporarily suppressed
  2. is easily influenced (eg describing a tic can cause a person to get tic)
  3. can increase with stress
  4. can increase (or decrease) during relaxation
  5. varies in strength and prevalence over time, transient symptom free periods
  6. may be present during sleep but usually disappears during sleep
  7. may decrease with distraction or concentration (especially with pleasurable activities)
  8. may decrease with fever

Although many tics can be temporarily suppressed, they are often perceived as involuntary.
The fact that tics can decrease with distraction or concentration is especially emphasized as a very special characteristic of tics, in contrast to other movement disorders where distraction and concentration usually leads to a worsening of the symptoms. In addition, tic conditions usually start abruptly and they often have accompanying sensory phenomenon, i.e. an inner tension or feeling before the tics, and with corresponding relief after the triggering of the tics. These sensory sensations that occur before, during and after tics have been shown to be a common but overlooked symptom of Tourette's syndrome.

Tics can be amplified to varying degrees by:

 

  1. anxiety
  2. nervousness
  3. boredom
  4. fatigue (tiredness)
  5. excitement
  6. to look forward to something
  7. menstrual cycle (premenstrual, estrogenic effect?)
  8. drugs, some (including sympathomimetics, amphetamine, l-dopa)
  9. jogging

The natural course of Tourette's syndrome varies considerably from individual to individual. Although the condition can range from very mild cases to a very severe condition, most individuals have only a mild degree of symptoms.

 

Examples of tics

Motor tics: Blinking of eyes, grimaces, wrinkles of the nose, rolling of the eyes (ceiling), closing of the eyes, row of tongues, squinting, slapping with lips, spitting, whiplash / headache, throwing on the hair, shaking the head, contraction of abdominal muscles, fiddling with clothes, biting nails, touch objects / on oneself or others, clapping, braiding fingers, banging with fingers, jumping tramping, kicking etc.

Vocal tics: Whistling, whistling, milling, whistling, raking, coughing, sniffing, stuttering, humming, grunting, screaming, short howls, yawning, stammering, repetition of words or expressions and more.

 

Additional difficulties with Tourette

At least 50% of those who take TS also have ADHD. About 30% have obsessions and compulsions. Other additional difficulties can be aggression, anxiety, depression, sleep problems, self-harming behaviors and learning difficulties.

Tourette's syndrome often also causes attention deficit, poor concentration, learning difficulties and can affect behavior. Special education is often required. 
The condition is severely underdiagnosed. Parents are often told that the symptoms are due to habits, nervousness, problems at home and "it probably goes away", which in many cases is poor advise.

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Written by

ove heradstveit

Ove Heradstveit

Psychologist, specialist in clinical community psychology. PhD.
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