Tourettes Syndrome in Children

Topics: Tourette syndrome, Tic, Tic disorder Pages: 5 (1836 words) Published: December 2, 2012
Tourette's syndrome, also called Tourette's disorder is named after the neurologist, Gilles de la Tourette. Sometimes it is referred to as GTS but more often it is simply called Tourette's or ‘TS’. It is an inherited neurological disorder marked by movement-based (motor) tics which are abrupt, repetitive, stereotyped, non-rhythmic movements, as well as vocal (verbal or phonic) tics which are involuntary sounds produced by moving air through the nose, mouth, or throat. Tourette's is defined as part of a spectrum of tic disorders, which includes transient and chronic tics. This disorder may appear in multiple family members, and often appears (co-morbid) with other behavioral disorders, in particular - “obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD)” (Hawley 2008). People with this disorder have normal life expectancy and intelligence, but symptoms can lead to decrease in normal activities (Walkup, Mink & Hollenbeck 2006). Tourette’s syndrome, as described in the psychiatric diagnostic tool DSM-IV-TR criteria is “associated with distress or social or functional impairment” (Hawley 2008). Onset and Diagnosis. The most common first sign to alert people to visit the doctor for a possible presence of Tourette’s is a facial tic such as “rapidly blinking eyes or twitches of the mouth” (NTSA 2009). Unintended, involuntary sounds such as throat clearing, shrugging or tics of the limbs may be initial signs but in certain case, although rare, the symptoms become abruptly with multiple symptoms of movements and sounds. Chronic tic disorder is diagnosed with the presence of single or multiple tics, and the presence of motor or phonic tics (but not both) which is present for a year or more. On the other hand, Tourette's which falls under the category of above is diagnosed when there are multiple motor tics occurring at the same time with one phonic tic and is manifested for more than a year. As a general rule, simple motor tics like blinking are first noticed on the child at around 5-10 years old, while vocal tics start manifesting after 8 years old but before the child is 15 years old. Symptoms of the disorder can be seen in infancy but this is a rarity. As a rule, the symptoms may come and go and children show identifiable signs at round 7 years old (Hawley 2008), and before 18-21years old (Black 2007). Studies found the most onset was between 9-14 years of age (Leckman 2003, Black 2007). Another study showed that tics started below 18 years, but 5 relatives had an onset after the age of 21 years. Affected persons will “blink, jerk, grunt, clear their throats, swing their arms, grasp or clasp others, have obsessive-compulsive behaviors or use verbal expletives (coprolalia) uncontrollably” (Tabers 2001, 2207). In some cases, people suffering from Tourette’s can control the verbal expletives in public but they will express it vigorously once they are in private. Coprolalia, “the uncontrollable utterance of socially objectionable or taboo words or phrases” is the most popular symptom of Tourette's but it is not required for a diagnosis hence about 90% of patients afflicted with it only Tourette's does not have coprolalia. The most common, initially noticed motor tic is eye blinking and the vocal tic is repetitive throat clearing (Black 2007). The disorder often persists throughout the individual’s lifespan but severity peaks in adolescence and thereafter decreases to a point that it is almost not bothersome to the person. This average though can be very misleading because some form of fluctuation or recurrence have been documented although it is not severe. There have also been rare cases that reported a recurrence of tics that is bothersome enough to seek medical attention, and have had to maintain lifelong treatment due to progressively worsening of tic activity (Black 2007). Prevalence. Tourette's syndrome used to be known as a rare condition but it is now contended by doctors...
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