Tourettes is a neurological disorder that causes a person to have tics—involuntary movements, thoughts, or words. It was first recognized by French physician Jean Marc Gaspard Itard in 1825, but it was not until 1885 that French neurologist Jean-Martin Charcot coined the term “Tourettes syndrome” after his resident assistant Georges Gilles de la Tourette published a study of nine persons with convulsive disorders.
To be diagnosed with Tourettes a person must suffer from at least two movement disorders and a verbal one for over a year. The type a movements a person may suffer varies widely, from eye blinking to leg kicking. A person normally develops Tourettes sometime during childhood Medication is rarely prescribed for the control of Tourettes. Most treatments focus on education and management of the most disrupting aspects of the syndrome. As a person with Tourettes reaches adulthood, the disorder may lessen. The average age when the condition is most severe is between eight and twelve years of age. While there is no test for Tourette’s syndrome, medical professionals have devised standards that assist physicians in diagnosis of the disorder. The following are the symptoms of Tourettes:
1. Compulsive Behavior
Compulsive behavior is one of the leading signs of Tourettes. While not everyone with Tourettes suffers from compulsive behavior, the Centers of Disease Control and Prevention estimates that over a third of these patients do experience compulsive behaviors. These compulsive behaviors may range from repeated hand-washing, checking and rechecking things, repeating words silently, counting, or even praying over and over again. Many people afflicted with Tourettes also suffer from obsessive-compulsive behavior.
Paul J. Lombroso and Lawrence Scahill published a study in 2007 that linked the two. “… Over half [of Tourette patients] also have significant obsessive-compulsive symptoms, and approximately 30% meet the diagnostic criteria for obsessive-compulsive disorder,” they reported. Obsessive-compulsive disorder is when a person struggles with unwanted thoughts or obsessions that lead him/her to feel compelled to respond to these thoughts. The person is compelled due to a sense of fear or stress if he refuses. When he acts on the compulsion, there is a temporary easing of the distress.
2. Hyperactivity
Hyperactivity is another very common symptom associated with Tourettes. Although Attention Deficit Hyperactivity Disorder is a completely separate condition from Tourettes, it frequently accompanies the disorder. ADHD is a condition where a person experiences habitual inattention and impulsive, hyperactive behavior that inhibits his or her development and daily life. This may present itself in several ways in the person’s life such as the inability to organize for completion of tasks, difficulty in listening, carelessness in school or work, the dislike of tasks that require long periods of concentration, and forgetfulness. A 2003 study published in the Journal of the American Academy of Child and Adolescent Psychiatry reported that nearly 65% of children with Tourettes also meet the diagnostic criteria for ADHD.
3. Lack of Restraint
Lack of restraint is another symptom of Tourettes. Experts term this lack of restraint as “dyinhibition.” A person with Tourettes may be unable to stop certain actions, thoughts or words. Kathleen J. Giordano and Margo Edelman write about children with Tourettes. “Inappropriate statements or behaviors result from the student’s inability to consistently apply ‘mental brakes’ – the child can’t stop himself consistently from expressing behaviors, thoughts, or displaying actions that someone else might be able to control,” they observed. Experts stress that this is very important to remember when dealing with a person suffering from Tourettes. If a supervisor or teacher does not understand this difficulty with restraint, they will often interpret the Tourettes sufferer’s behavior as willfully disruptive, disrespectful or defiant. Some experts believe this lack of restraint is due to the chemical imbalances in the Tourette sufferer’s brain.
4. Jerking Muscle Spasms
Another symptom of this condition is jerking muscle spasms. While the syndrome may first present itself with simple motor actions such as coughing or sniffing, it can develop into more pronounced movements. These are sudden, involuntary movements of large groups of muscles and may result in jumping, kicking, vomiting or even the display of obscene gestures. Tourettes patients report that they often experience a warning sensation in the part of the body before it spasms. Some describe this premonitory urge as an itch. Others report it as a tingle or tension. Once a person completes the involuntary spasm, the tingling or itching sensation is relieved.
5. Tic
The most common symptom that a person experiences with this disorder is a tic. This is an involuntary, sudden movement or sound that a person makes. These may either be motor or phonic actions. Motor tics are actions made with a specific part of the body. This may be as simple as eye blinking or coughing. It may be a complex motor action such as hopping or stepping in certain patterns. Phonic tics are either words or sounds a person makes involuntarily. These may be as simple as grunting or as complex as repeating words or phrases, or even saying vulgar or obscene words. These involuntary movements may range from mild to severe and are aggravated by stress, illness, or fatigue.
6. Anxiety
Anxiety is also one of the signs of Tourettes. “Anxiety and depression, which in the general population often emerge in adolescence and adulthood, are more likely to emerge early in life with TS, sometimes as early as age 5,” writes Jeremiah Scharf, assistant professor of neurology at Harvard Medical School. Experts believe one reason for higher levels of emotional stress in Tourette patients is the co-morbidities of OCD and ADHD that are very common for Tourette sufferers. “…Both mood and anxiety disorders are significantly more common in TS patients with a concomitant diagnosis of OCD or of combined OCD and ADHD,” writes Pete Farley on the findings of a study by the University of California-San Francisco.
7. Involuntary Body Movements
Finally, involuntary body movements are a symptom of the syndrome. These often begin early in childhood, with the median age of onset being seven years of age. These movements may be small such as eye blinking or nose twitching. Often these involuntary movements occur in the face and neck. Though these movements often begin in the facial area, they can spread to involve other muscles in the body. This can include kicking of the legs, arm thrusting, and jumping. Fortunately, the symptoms often decrease as a person matures. In nearly 30% of cases the symptoms will disappear when a person reaches young adulthood.
