Gilles de la Tourette Syndrome


Gilles de la Tourette syndrome (SGT) is a neurological disorder characterized by uncontrollable tics. The disease, which appears during childhood, is cyclical and its symptoms are intermittent. It is named after the French neurologist who first described its symptoms back in 1885.

Causes

It is not known what causes GTS. Several theories, ranging from genetic factors to brain chemistry and brain structure and even childhood infections, have been proposed. What we do know however, is that boys are more likely to develop the disorder and that people with a family history of the syndrome are also more at risk. It would also appear that children born prematurely have a greater risk of developing Tourette's syndrome.

Symptoms

The most common symptoms of GTS are characterized by involuntary and repetitive physical tics and vocalizations. There are several types of tics including:

Motor tics
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  • eye blinking (one or both)
  • spitting
  • facial contortions
  • raising shoulders
  • folding and unfolding fingers
  • mimicking the gestures of others (echopraxia)
  • rubbing one's nose
  • touching others
  • banging one's head
  • biting one's lip
Vocal Tics (phonic)
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  • making sounds (barking, meowing, etc.)
  • sniffing
  • throat clearing
  • spontaneously uttering swear words or vulgarities (coprolalia)
  • repeating the same words over and over
  • repeating words just heard (echolalia)
  • using different intonations

Anxiety, stress, fatigue and excitement can increase the incidence of tics. At the other end of the spectrum, sleep, relaxation and concentration are likely to improve the situation and lessen the occurrence of tics. It may be possible to suppress a tic for a few minutes but it is almost impossible to completely prevent it from happening. Persons with Tourette's equate it to holding back a sneeze. Suppressing tics may cause them to intensify.

Other symptoms can present with tics. In fact, obsessive compulsive disorder (bipolar disease), hyperactivity and attention deficit disorder may be associated with tics. The following symptoms may also be observed:

  • anxiety
  • temper tantrums
  • depression
  • immaturity
  • impulsiveness
  • lack of inhibition
  • learning difficulties
  • sleep disorder

Course of the disease

The first signs of GTS are generally simple motor tics that appear during childhood, between the ages of 7 and 10 years. They can, however, appear at a much younger age or later on, between 2 and 15 years of age. Adolescence is a difficult stage and tics may intensify and become more frequent during this period. It should be noted however, that tics are intermittent. There may be long periods, lasting up to a year, during which time no tics occur. Many sufferers see their symptoms disappear as they reach adulthood, while others see a significant improvement in their symptoms. Some however, do not experience any changes.

Diagnosis

Gilles de la Tourette syndrome is diagnosed by a physician or a neurologist. Since the disease is neurological rather than psychiatric, consulting a psychiatrist is not necessary. However, given the nature of some of the symptoms that may occur as a result of the disease, consulting with a psychiatrist may prove beneficial for some.

There is no diagnostic test to determine with certainty whether one has GTS. Analysing the symptoms is often enough. To be diagnosed with Tourette's one must have multiple motor tics and at least one phonic tic. Furthermore, symptoms must have appeared before the age of 21 years and have been present for at least 1 year. A few additional tests are conducted to ensure that there are no neurological problems. That being said, the physician may ask for blood tests, an electroencephalogram or a magnetic resonance image of the brain.

Treatment

Since there is no cure for the disease, treatment is centered on reducing symptoms. A combination of drugs is often used to treat the tics and other associated disorders (if present) such as hyperactivity, attention deficit or depression.

Psychotherapy is also recommended for persons with GTS. In fact, social integration and self-esteem are often gravely affected and psychotherapy can help manage this aspect of the disorder. Family therapy may also be beneficial for the loved ones of GTS sufferers.

For more information or for support:

Association québécoise du syndrome de la Tourette
7070 boul. Perras, Montréal (Québec) H1E 1A4
Telephone : (514) 328-3910
Website :http://www.aqst.com

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