Tourette syndrome is defined as the presence of movement and vocal tics for more than one year beginning prior to age 21 years. Tics are involuntary, rapid, and repetitive movement of muscle groups. Individuals with tics have an urge to make the movement and a sense of relief after the movement is complete. The tics or movements may be motor (movement of a body part) or vocal. Tics often start around age six and worsen during puberty. Patients with tics often have a family history of tics.
Symptoms
Motor Tics
- Simple motor tics: Fast, darting and meaningless movements.
- Complex motor tics: may be slower and consist of a series of repetitive movements which may appear purposeful.
Vocal Tics
- Simple vocal tics: meaningless sounds and noises.
- Complex vocal tics: interruption of speech by words and phrases
- Coprolalia: The most socially distressing vocal tic involves explosive utterance of obscene words. This occurs in only a minority of Tourette’s syndrome patients, but is the most well know symptom. However, the majority of patients do not ever exhibit this symptom.
Behavior
Obsessive Compulsive Behavior
Attention Deficit Hyperactivity Disorder
Treatment
Monitoring
- Symptoms when mild do not require any treatment but it is helpful to define symptoms related to Tourette’s and any related difficulties.
- Education and reassurance: Educating the child, parents and teachers is very beneficial in reducing stress and anxiety associated with movement and related behavior symptoms.
Pharmacological treatments may include:
- Haloperidol (Haldol ®): This has been the mainstay for the treatment of Tourette’s. Many patients may improve with haloperidol; however side effects such as parkinsonism and drowsiness can limit its use.
- Pimozide (Orap): This was approved in the U.S in 1984 for treatment of Tourette’s. It is generally better tolerated than haloperidol and is often equally effective.
- Clonidine (Catapress) and Fluphenazine are some of the other medications that are used for movement related tics.
- Clomipramine is helpful for treatment of obsessions and compulsions.
- Family and patient counseling and psychotherapy are also very helpful.
For More Information
Tourette Syndrome Association