What is Tourette Syndrome? Let's talk about it simply.

Have you ever noticed that sometimes young children, and sometimes adults, blink their eyes continuously, or shrug their shoulders, or suddenly make a throat clearing sound? It seems like these things are happening to them without their control, right? Tourette syndrome is a neurological condition that causes such uncontrollable movements or sounds. We call these tics in medical terms. Don't be afraid when you hear this. The most important thing is to be fully aware of this.

Simply put, what is Tourette Syndrome?

Tourette syndrome is a neurological disorder that causes a person to make sudden, involuntary movements or sounds that they cannot control. These are called `tics`. For example, a person may blink their eyes repeatedly, clear their throat, or utter words they don't mean.

For some people, treatment helps control these tics. But for others, these symptoms are not so bothersome that they don't need any medication at all.

This condition often begins in childhood. It is also more common in boys than girls. The best part is that these symptoms often decrease as children grow older. In some cases, they disappear completely.

Why does this happen? What are the reasons?

Doctors are still trying to figure out exactly what causes Tourette syndrome, but they believe it is linked to changes in the functioning of several parts of the brain. Researchers believe that changes in the basal ganglia, which helps control body movements; the frontal lobes, which control muscles; and the cortex, which helps communicate between different parts of the brain.

In addition, an imbalance in the chemicals that carry messages to the brain, called `neurotransmitters,` may also be a cause. The main ones are `(dopamine)`, `(serotonin)`, and `(norepinephrine)`.

In addition to these, there are other reasons that are not yet fully proven, but are thought to be influential:

• Complications during pregnancy
• Low birth weight
• Head injuries
• Carbon monoxide poisoning
• Encephalitis

Is this something that comes from generations?

Researchers believe that Tourette syndrome or similar tic conditions may be hereditary to some extent. This means that there may be a genetic link. Although it is not yet clear exactly how this happens, a person with Tourette syndrome has about a 50% chance of passing it on to a child. However, in some families, several people have the condition, while in others, only one person may have it. Also, about one in 20 children with the condition has no family history of the condition.

What are the symptoms of Tourette syndrome (Tics)?

The main symptom of Tourette syndrome is `tics`. Some `tics` are so small that they are not even noticeable. But some are frequent and obvious. They can be aggravated by things like stress , excitement, illness, or fatigue. Severe `tics` can sometimes cause embarrassment and interfere with social life or work.

Before a motor tic occurs, some people may feel a tingling, prickling, or tightness in their body. The discomfort disappears when the tic, or movement, occurs. You may be able to stop the tics for a while, but you may not be able to stop them completely.

There are two main types of `tics`. They are `motor tics` and `vocal tics`. Each of these types is further divided into two categories: simple and complex.

The truth about using foul language (Coprolalia)

One of the most confusing symptoms of Tourette syndrome is `coprolalia`. This is the uncontrolled utterance of bad words or socially inappropriate things. Similarly, the uncontrolled making of obscene gestures is called `copropraxia`. Because people with the condition are portrayed on TV and in movies, many people think that this is very common. But the truth is, most people with Tourette syndrome do not have `coprolalia` or `copropraxia`.

Other related conditions

Although the exact cause is not clear, about half of people with Tourette syndrome also have symptoms of ADHD (Attention Deficit Hyperactivity Disorder), which means they have difficulty paying attention, staying focused, and completing tasks.

In addition, Tourette syndrome may also be associated with these conditions:

• Anxiety
• Learning disabilities, for example dyslexia
• Obsessive-compulsive disorder (OCD) is a condition in which unwanted thoughts and actions cannot be controlled, for example, constant hand washing.

How does a doctor know for sure if this is Tourette syndrome?

However, your doctor may need to check for other possible causes of your tics. For example, constant eye blinking could be due to poor eyesight, or constant nose picking could be due to an allergy. In such cases, you may be referred for tests such as blood tests or an MRI scan of your brain. You may also be asked to do an EEG (electroencephalogram), which measures brain wave patterns.

Your doctor may ask questions like these:

• What inspired you to come here today?
• Do you or your child have uncontrollable body movements? How long has this been going on?
• Do you hear words or sounds coming out of your mouth without thinking? When did this start?
• Does anything make these symptoms better? What makes them worse?
• Do you or your child have anxiety or difficulty concentrating?
• Does anyone else in the family have these symptoms?

In addition, the doctor also considers these criteria:

• Do `tics` belong to both the categories of movement and sound (they don't have to happen at the same time).
• No matter how many times a day they come, will these last for at least a year?
• Did it start before the age of 18?
• Aren't these things caused by medications or other substances?
• Do the tics vary in frequency, type, severity, or from simple to complex?

What are the treatments for this?

There is no cure for Tourette syndrome yet. However, for most people, the tics are not severe enough to require treatment. However, if they are interfering with your life, your doctor may prescribe medication.

Medications

There are several types of medications that can help reduce `tics.` Some of these are also prescribed for other conditions. That's because those medications have also been found to reduce `tics.`

• Drugs that affect dopamine: Fluphenazine, Haloperidol, Pimozide, Risperidone.
• Medications for high blood pressure: such as `Clonidine`, `Guanfacine`.
• Antidepressants: Fluoxetine (Prozac), Sertraline (Zoloft).
• Medications for ADHD: such as `Methylphenidate (Ritalin LA)`.
• Medications for epilepsy: such as `Topiramate (Topomax)`.

Therapy

In addition to medications, therapeutic treatments are also very helpful in managing this condition.

• Talk therapy: You can talk to a psychologist or trained therapist to learn how to deal with Tourette syndrome and related conditions like ADHD, OCD, or anxiety.
• Cognitive Behavioral Therapy (CBT): This involves identifying the sensations that precede the tics and practicing doing something else in response to them. This can be a great help in controlling the tics.
• Deep Brain Stimulation (DBS): This is still an experimental treatment. It is considered for people with very severe cases who have not responded to other treatments. In this, a device is surgically implanted that delivers electrical stimulation to the parts of the brain that control movement.

Tips for parents caring for a child with Tourette syndrome

Caring for a child with this condition can be a challenge for parents. Remember, tics often peak in the child's early teens and gradually decrease as they get older.

In the meantime, here are some things to help you:

• Don't force your child to stop their tics. It may be distressing to see or hear them, but trying to control them can increase the child's stress and make the tics worse.
• Inform the adults in the child's life. Inform the school teachers, the school van driver, the class teacher, and the coaches who the child spends a lot of time with. Explain the situation to them and get the support the child needs.
• Help build your child's self-esteem. Encourage your child to pursue interests and talents (such as sports, art, music). This will help them make friends, learn new things, and build self-confidence.
• Teach your child how to deal with other people's jokes. Talk to your child and train him on how to respond to other children's jokes and questions.
• Get support too. Find out if there are support groups for parents of children like this. That will give you a lot of strength too.

Tourette Syndrome, tics, tic disorder, pediatrics, neurological diseases, mental health, ADHD, OCD