WHAT IS TOURETTE SYNDROME?


Tourette Syndrome
  Gilles de la Tourette syndrome (Tourette Syndrome or TS) is a neurological disorder which becomes evident in early childhood or adolescence between the ages of 2 and 15.  Tourette syndrome is defined by multiple motor and vocal tics lasting for more than one year.  Many people have only motor tics or only vocal tics.  The first symptoms usually are involuntary movements (tics) of the face, arms, limbs or trunk.  These tics are frequent, repetitive and rapid.  The most common first symptom is a facial tic (eye blink, nose twitch, grimace), and is replaced or added to by other tics of the neck, trunk, and limbs. 

These involuntary (outside the patient's control) tics may also be complicated, involving the entire body, such as kicking and stamping. Many person report what are described as premonitory urges -- the urge to perform a motor activity. Other symptoms such as touching, repetitive thoughts and movements and compulsions can occur. 

There are also verbal tics.  These verbal tics (vocalizations) usually occur with the movements; later they may replace one or more motor tics.  These vocalizations include grunting, throat clearing, shouting and barking.  The verbal tics may also be expressed as coprolalia (the involuntary use of obscene words or socially inappropriate words and phrases) or copropraxia (obscene gestures). Despite widespread publicity, coprolalia/copropraxia is uncommon with tic disorders.

Neither echolalia (echo speech) or coprolalia/copropraxia is necessary for the diagnosis of Tourette syndrome.  All patients have involuntary movements and some have vocalizations.  Echo phenomena are also reported, although less frequently.  These may include repeating word of others (echolalia), repeating ones own words (palilalia), and repeating movements of others. 

Although the symptoms of TS vary from person to person and range from very mild to severe, the majority of cases fall into the mild category. Associated conditions can include attentional problems (ADHD/ADD, impulsiveness (and oppositional defiant disorder), obsessional compulsive behavior, and learning disabilities.  There is usually a family history of tics, Tourette Syndrome, ADHD, OCD.  Tourette Syndrome and other tic disorders occur in all ethnic groups.  Males are affected 3 to 4 times more often than females.

Most people with TS and other tic disorders will lead productive lives.  There are no barriers to achievement in their personal and professional lives.  Person with TS can be found in all professions. A goal of TSA is to educate both patients and the public of the many facets of tic disorders.  Increased public understanding and tolerance of TS symptoms are of paramount importance to people with Tourette Syndrome. 

The disorder was named for a French neuropsychiatrist who successfully assessed the disorder in the late 1800's:

Georges Gilles de la Tourette
Georges Gilles de la Tourette (born Georges Albert Edouard Brutus Gilles de la Tourette!) in 1857 was a French physician (today he would be described as a neurologist) who  made several valuable contributions to medicine and literature.    The first reported case of Tourette syndrome was by another French doctor named Itard in 1825.  Dr. Itard described the case of Marquise de Dampierre, a woman of nobility who was quite an important person in her time.  In 1885 Dr. de la Tourette described nine patients with the syndrome of multiple motor and vocal tics. His major contribution was to define these patients as having a movement disorder that now bears his name

Articles:

AJ Lees,Georges Gilles de la Tourette: The Man And His Times, Rev. Neurol. (Paris), 1986, 142, 11, 808-816.

Howard I. Kushner, Medical Fictions: The Case of the Cursing Marquise and the (Re)Construction of Gilles de la Tourette's Syndrome, Bull. Hist. Med., 1995, 69:224-254.

Howard I Kushner and Louise S Kiessling,The Controversy over the Classification of Gilles de la Tourette's Syndrome,1800-1995, Perspectives in Biology and Medicine, Vol 39/3, Spring 1996.

 

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