Tourette syndrome or TS is a Neurodevelopmental or brain-based condition that can cause people who have it to make erratic movements and sounds known as tics.
What is a tic?
Tourette Syndrome (TS) tics are quick, repetitive, intermittent, unplanned, rhythmless, involuntary sounds or movements. Tics responsible for sounds are known as “phonic or vocal tics”, while tics that produce movement are called “motor tics.
Typical examples of involuntary vocal tics include sniffing, throat clearing, humming, uttering single syllables (e.g. uh-uh-uh) and grunting. Intricate vocal tics could involve speaking linguistically meaningful utterances (words and phrases), or changing the frequency and volume of voice and it could even include apparent repetition of a phrases or a rhyme a sufferer has heard over and over (echolalia), repeating one’s own words (palilalia) or uttering profane or socially taboo phrases (coprolalia).
Simple motor tics, on the other hand, involves one muscle group and include tapping, lip-licking, blinking, shoulder shrugging, leg shaking and head jerking. Complex motor tics could consist of an organised movement produced by some muscle groups. Examples of this would be, jumping, spinning around or jumping. Extreme motor tics may also include inappropriate or taboo gestures of behaviour (copropraxia) or copying someone else’s actions (echopraxia).
It is important to note that the tics linked with Tourette syndrome is the result of a neuropsychiatric condition. The sounds and movements the sufferer exhibit are involuntary and are not done because they want to.
How is a person with TS affected?
Tics can be very discomforting to a person who is suffering from it. It doesn’t matter if it is complex or simple as they can be embarrassing and troubling. In some cases, people with tics complain of having headaches, soreness and muscle strains. It’s so sad that cases of repetitive strain injuries have been reported.
Because tics are wholly involuntary, they can occur anywhere and anytime, especially in the work area. This can be stigmatising and embarrassing as it makes people with it appear different.
Parents of kids who suffer from TS usually worry about the psychological implication of tics and how it affects them in the society.
How do other children see their kids? How the school teachers handle them around other kids? Do they get bullied for having Tourette syndrome? Do they get teased in class? If they are able to make friends? Are they allowed to play with other kids their age? Tons of questions would definitely flash through any parents minds.
Are tics suppressible?
The feeling you get before you get the urge to sneeze, or the need to scratch an insect bite that itches, or the urge to cough is known as “premonitory urge”, and many people with TS have described this feeling before a tic builds up. With tics, this urge is likened to a buildup of pressure or discomfort that is suppressed when the tic is expressed.
The transient ability to suppress a tic can be likened to the feeling you get when you are holding a sneeze or when you resist the urge not to scratch an itch. Although the ability to hold a tic varies from one individual to another depending on the severity of the tic, it also requires a lot of energy and can very exhausting.
Young people (children) can either be aware or not aware they have Tourette syndrome, and even if they are aware, it isn’t advisable to ask them to suppress their tics because the efforts required in suppressing the tics would need efforts far beyond what they can handle, and this could make concentrating on other things difficult.
When in environments that can support children or teens with TS that experience tics when they tic, there is a remarkable decrease in the number of tics they experience. It was thought that suppressed tics causes a rebound effect after suppression is stopped.
This expresses the entire tics that had been suppressed, but a recent study makes us understand that the rebound effect isn’t exact. The research shows that the number of tics does not considerably increase after a period of suppression episodes.
Parents also observed that their children would come home and explode in bouts of tics after suppressing their tics while at school but this is also followed by other emotional behaviours. You could consult your doctor for professional opinions.
What causes Tourette syndrome?
Tourette syndrome is passed from parents to the child. This means it is hereditary, but it doesn’t necessarily indicate that if someone has TS, their son or daughter would be born with it. The chances of passing TS to a child are between 5 – 15%.
Earlier scientific studies had it that TS was carried in a single gene, but more light has been shed in that area, and we now know that TS involves multiple genes. Although it appears that there is a possible significant genetic factor, some studies indicate perinatal, prenatal, autoimmune, and environmental factors may contribute to or maximise the severity of symptoms.
When do tic symptoms start?
It is no surprise to find young children show signs of tics. The symptoms of Tourette Syndrome usually begins in children around the age of five but may occur in even children as young as one or two and as old as 17. You could typically notice the first signs of facial tics manifest as blinking, grimacing or nose twitching.
Reasons why people tic?
Presently, the basal ganglia and the frontal lobes of the cerebral cortex are said to be involved in Tourette syndrome. Brain imaging analysis suggests that individuals with TS have neurological differences in their brains, specifically in their cortico-striatal-thalamo-cortical (CSTC) circuitry. Also, the frontal lobes create and execute mobility thoughts, while the basal ganglia act as a brake to stop unwanted movements and sounds.
For people with TS, something unusual happens when the frontal cortex “tells” the basal ganglia to put a hold on certain movements. This results in unneeded tics, sounds or movement. More researches are still done to understand TS fully.