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10 May 2010

What makes Tourette's tick?

Mild tics are quite common in children and usually resolve spontaneously. However, in some people, tics become chronic and interfere with daily life.

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Mild tics, generally of only one form, are quite common in children and usually resolve spontaneously after weeks or months. However, in some people, tics become chronic and interfere with daily life.

In such cases, the diagnosis of Tourette’s disorder should be considered.

Tourette’s disorder is named after the doctor who first described it. It is a chronic neurological disorder which features tics (sudden, brief, repeated, stereotyped movements and vocal sounds, which are not rhythmic and serve no useful purpose).

Typical tics
Typical tics can include a variety of rapid, unnecessary, muscular movements: from eye blinking or rolling, shrugs, jerking of the head, clearing of the throat, to grimaces, touching and smelling things, or hopping or flapping motions.

Vocal tics range from simple, meaningless noises or odd sounds, snorting, barking and laughing, to meaningful words or phrases blurted out.

The tics occur often, usually in bouts, almost every day, though they may vary in intensity and may be worsened by tension. They are unwelcome, and as hard to suppress as the urge to sneeze. Similarly to the sneeze, it can be very uncomfortable to try to suppress them and there can be a feeling of relief afterwards.

The condition usually starts before one is eighteen. Such tics can be very embarrassing and can lead to ridicule or scolding from others who don’t understand the condition. One may feel embarrassed when they happen in public, and anxious when anticipating that this may occur. They can interfere with one’s normal social and work functioning.

What are the causes?
The exact cause is not yet known but there is a strong tendency for the condition to run in families.

It appears to involve abnormalities in the metabolism of the chemical dopamine in the brain, and other brain chemicals may be involved.

Where to go for help
If you are concerned that you or your child may have Tourette’s disorder, it is important to seek the help of a psychiatrist or neurologist. Treatment usually consists of a combination of medication and psychotherapy. Support groups can also play an important role in helping one cope with the condition.

Support group in the Western Cape:  082 9244909 

(Ilse Pauw, Health24)
Reviewed by Prof M. Simpson, MB., BS. (London ); MRCS, LRCP; MRCPsych, DPM.

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