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Gilles de la Tourette's syndrome
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Tourette's
syndrome is a disease in which the patient has repeated, jerking movements of parts of the body and may yell things out. The condition is usually first diagnosed in childhood, and is sometimes associated with other psychiatric problems. Diagnosis is based on symptoms. Treatment is with medications.
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- This disease begins in childhood, usually between the ages of 2 and15.
- The most common symptom is motor tics (seen in about 80% of people with this disease). Tics are quick jerky movements of different parts of the body that can occur separately or in rapid sequence.
- Motor tics can be very simple, such as a jerking motion of the arm, or more complex, such as frowning, shoulder shrugging, or head thrusting.
- Sometimes, more harmful tics (i.e., nail biting, hair pulling, or lip biting) may be present.
- People with this disease often feel a build-up of tension before they have their tic, and feel better and more relaxed after the tic has passed.
- Most people with the disease also have phonic tics in which they yell out things.
- These verbal ejaculations may be simple, such as grunting, coughing, or barking.
- Others may have more complex phonic tics, such as endlessly repeating words, yelling profanity, repeating other's phrases, or imitating their movements.
- People with this disease have a higher rate of psychiatric disorders. For example, obsessive-compulsive disorders are seen much more often in people with Tourette's syndrome.
- There are also social issues that people with this disease have to deal with, as the tics often create uncomfortable situations for them. They may yell things inappropriately, or have jerking movements at very awkward times.
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- The cause of this disease is not known.
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- The symptoms usually suggest the diagnosis.
- The physical examination is usually normal.
- CT scans and MRI scans are normal as well, and may not even need to be done.
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- This is a life-long disease, and patients with it may have an up and down course.
- Medicine usually helps decrease some of the symptoms.
- Haloperidol is the drug most often used. The dose is adjusted according to individual response.
- Other drugs that are sometimes used include Clonazepam, Clonidine, Fluphenazine (Prolixin), or Pimozide. Other drugs may also be tried, but they have not been proven to be effective.
- Treatment is usually continued for life.
- Some people with this disease may temporarily control their symptoms. By yelling and getting out their tensions, they can sometimes stop their symptoms for a short time.
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