What is Tourette Syndrome?
Tourette Syndrome, (TS), is a neurological disorder characterised by involuntary, irresistible, rapid, repetitive and involuntary muscle movements and vocalisations called “tics”, and often involves behavioural difficulties.
The term “involuntary”, used to describe tics, is confusing as most people with TS do have some control over their symptoms. However, the control which can be exerted, from seconds to hours at a time, only delays more severe outbursts of symptoms.
Tics are experienced as a build up of tension, are irresistible and eventually must be performed. Typically tics increase as a result of tension or stress and decrease with relaxation or concentration on an absorbing task. TS symptoms have long been misconstrued as a sign of behavioural abnormality or “nervous habits”, which they are not.
The two categories of the tics of TS and some common examples are:
- eye blinking
- head jerking
- shoulder shrugging
- facial grimacing
- nose twitching
- throat clearing
- barking noises
- tongue clicking
- touching other people and things
- twirling about
- repetitive movements of the torso or limbs
- pulling at clothing; and
- self-injurious actions including hitting or biting oneself
- uttering words or phrases
- coprolalia (the involuntary utterance of inappropriate or obscene words)
- echoalia (repeating a sound, word or phrase just heard); or
- palilalia (repeating one’s own words)
The variety and complexity of tics or tic-like symptoms that can be seen in TS is enormous.
People with TS rarely have all of these symptoms. Mostly they will exhibit some of the symptoms over a long period of time in varying degrees.
A mild case will have a few tics or twitches possibly confined to the face, eye and shoulder areas. In more severe cases several areas of the body may be affected.
The symptoms can vary in degree from day to day.
PANDAS is an acronym for a condition called Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). Current research suggests that symptoms of Tourette’s and OCD have been associated with PANDAS at least in some cases. PANDAS results from the effect of the body's own immune system's antibodies attacking parts of the brain. The onset usually occurs following an ear, nose or throat (ENT) infection from Group A Beta Haemolytic Streptococcus (GABHS). GABHS antibodies in some cases can damage parts of the brain resulting in a range of behavioural disorders. OCD, Oppositional Defiant Disorder, Tourette’s, ADHD and even psychosis.