Tourette Syndrome Analysis

Overview
Tourette Syndrome (TS), also named multiple tics-coprolalia syndrome, was initially described by Gilles de la Tourette in 1900. It is a “developmentally regulated neurobehavioral disorder characterized by multiform, frequently changing motor and phonic tics.” (Brunn, Cohen, &Leckman, 2012) Tics means “involuntary, rapid repetitive and stereotyped movements of individual muscle groups.” (Brunn, Cohen, &Leckman, 2012) Although the definite cause of TS is unknown, it is well recognized that both genetic and environmental factors are linked to the TS. The potential cause of TS could be basal ganglia dysfunction and abnormal activity of dopamine (Albin & Mink, 2006). TS affects people from all racial and ethnic groups. Males are affected
In general, the course of TS is punctuated by the presence of new tics and the disappearance of older ones. During adolescence the symptoms have the tendency to be more unpredictable from day to day. However, in estimably 30-40% of the TS cases, the tic symptoms will remit completely by puberty (Robertson, 2000).
A recent study shows that there was a mean tic onset at age 5.6 years and then it was followed by tic worsening. The greatest tic severity occurred at age of 10. About half of the patients were virtually tic free by age 18 (Robertson, 2000).
Treatment Options
The most commonly used medications for TS are dopamine antagonists, pimozide, splurged, and tiapride. Also, Clonodine is widely used and has been reported to improve tics, ADHD, and behavior issues. In addition, the SSRIs, serotonin and clomipramine are being increasingly examined and successfully used in the pathophysiology of TS. Novel treatments such as immunomodulatory therapy, antiobiotics, antiviral agents, melatonin, psychosurgery and even laser therapy have all been proved to be successful in treating TS (Robertson,
However, in a recently performed controlled outcome study, exposure and response prevention (ER) was found to be effective in the treatment of tics in TS. In ER treatment, the sequence of a premonitory sensation and a following tic is interrupted, thus preventing the tic (Verdellen, Hoogduin, Kato, Keijsers, Cath, &Joijtink, 2008). Also, relaxation has been proved to be able to reduce severity of tics. Three longterm case studies have examined the relationship between stress and TS and shown that increased stress increases tics, whereas reduced stress such as relaxation reduces tics (Robertson,