Turrets syndrome – Symptoms, Treatment

What is Turrets syndrome ?

Turrets syndrome is a neurological condition, wherein an affected individual makes unusual sounds and movements and which generally cannot be controlled by them. Such movements are often referred to as tics. Repetitive shrugging of shoulders, blinking of the eyes and jerking the head are some of the examples. Occasionally, one may suddenly blurt obscenities.

Turrets syndrome shows it’s symptoms in childhood, somewhere between 7 and 10 years of age. The male population is 3 to 4 times more likely to get affected by the condition than the female population.

Even though there is no cure for Turrets syndrome, one can lead a normal life. If the signs are not causing any disruption of daily life or causing trouble, then treatment may not be required. On most occasions, Turrets syndrome tends to disappear as affected children reach adolescence.

Symptoms of Turrets syndrome

Tics, which are short, abrupt and intermittent sounds and movements, are the main symptoms of Turrets syndrome. The signs can be severe, mild or incapacitating.

Some of the categories of tics are as follows:

• Complex tics are peculiar, unique along with synchronized movement certain group of muscles
• Simple tics are abrupt, very short and may be repetitive, that involves lesser number of muscles.

The type of movements involved in tics include the facial tics, involving blinking of eyes, which usually start ahead of vocal tics. The method and the manner of expression may vary, which can’t be pinpointed.

The common tics experienced in Turrets syndrome include:

Vocal tics:

• Complex tics such as repeating own words and phrases, repeating words and phrases of others, using different intonations of voice and use of expletives
• Simple tics such as yelling, clearing of throat, hiccupping and barking

Motor tics:

• Complex tics such as touching other people, smelling objects, touching the nose, flapping of the arms, hopping and making obscene gestures
• Simple tics such as head jerking, shoulder shrugging, eye blinking, flexing finger, sticking the tongue out and darting of eye.

Over the passage of time, the frequency, severity and the method of tics can vary. At the time of sickness, stress and excitements the symptoms may worsen. Before the start of motor or vocal tics, one may experience the premonitory urge, which is a discomforting bodily sensation akin to itching, tingling or tension. This type of expression brings relief for the person who is suffering from Turrets syndrome.

The Turrets syndrome is usually at its peak during the teens, which improves on its own in adulthood. The tic may stop when it finds a lesser alternative for exposing the Turrets syndrome.

If the parents notice an unusual behavior and movements in their child, then they should consult a pediatrician because all tics can’t be considered as Turrets syndrome. Even though the tics may vanish without treatment, within few weeks or months in some children, consulting a doctor would help to avoid future health hazards.

Some of the complications of Turrets syndrome include:

• Patients with Turrets syndrome may have an active, healthy normal life. But living with this Turrets syndrome can increase the risk of behavioral abnormalities, social challenges and learning, which may affect their self image.
• Persons affected by Turrets syndrome may also suffer from the related conditions. They are:
  • Disability in learning
  • Depression
  • Sleep disorders
  • Anxiety disorders
  • ADHD
  • Obsessive Compulsive Disorder

Causes of Turrets syndrome

The cause of Turrets syndrome is unknown, but it is widely believed that genetic and environmental factors are the cause for the condition. The prevailing theories about the cause of Turrets syndrome are:

• Abnormality of brain: Abnormalities of the neurotransmitters in the brain as well as irregular levels of serotonin and dopamine may be a factor in the development of Turrets syndrome.
• Genetics: It is believed that Turrets syndrome may be an inherited genetic disorder. One genetic mutation has already been identified as a rare reason for Turrets syndrome.
• A family history of having Turrets syndrome and tics may increase the risk to developing Turrets syndrome.

There is no treatment to cure the Turrets syndrome. However, all possible treatments are directed towards the tics that interfere with a person’s daily activities. If the tics are not severe, no treatment is required.

Medications

No medicine gives complete relief for Turrets syndrome. Moreover all medicines for Turrets syndrome have side effects. However the symptoms and the related conditions can be controlled by the following medications:

• Methylphenidate and dextroamphetamine stimulants are given for increasing the concentration of mind and learning.
• Fluphenazine or pimozide is given to block or destroy the neurotransmitter dopamine, and to control tics. But these drugs may result in side effects such as dulling of the mind and gaining weight.
• Giving an injection of Botulinum toxin type A, into the affected muscles, helps to get relief from simple oral tics.
• Fluoxetine and other antidepressants are given to control OCD that may result as a complication of Turrets syndrome.
• Clonidine or guanfacine of central adrenergic inhibitors are given for controlling high blood pressure and behavioral symptoms. Increased sleepiness is a possible side effect

Therapies for Turrets syndrome

 The following therapies are given for Turrets syndrome:

• Deep brain stimulation for controlling tics that do not respond to medications or other forms of treatment
• Psychotherapy for controlling obsessions, depression and anxiety.