Child tourettes symptoms: Pediatric Tourette Syndrome | Children’s National Hospital

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Pediatric Tourette Syndrome | Children’s National Hospital

What causes Tourette’s disorder?

Tourette’s disorder is an autosomal dominant disorder. Autosomal means that both males and females are affected, and dominant means that 1 copy of the gene is necessary to have the condition. This means that a parent with TD or a parent who has the gene for TD has a 50/50 chance, with each pregnancy, to pass the gene on. TD is associated with a nongenetic cause in 10% to 15% of children. Complications of pregnancy, low birth weight, head trauma, carbon monoxide poisoning, and encephalitis are thought to be associated with the onset of nongenetic TD.

Dominant disorders exhibit something known as incomplete penetrance, which means that not everyone with the gene will have symptoms of Tourette’s disorder. In other words, if a parent passes the gene on to a child, the child may not have any symptoms of the disorder. If a daughter inherits the gene, there is a 70% chance that she will have at least 1 of the signs of TD. On the other hand, if a son inherits the gene, there is a 99% chance that he will have at least 1 of the signs of TD.

Finally, dominant disorders can also exhibit something known as variable expressivity. This means that there are differences in the expression of the TD gene in different people. For example, 1 person with TD may have obsessive-compulsive disorder, while another has a chronic tic disorder, while another has full-blown TD. In addition, there are differences in expressivity between males and females: males are more likely to have full-blown TD or chronic tics, while females are more likely to have obsessive-compulsive disorder (OCD), an anxiety disorder in which a person has an unreasonable thought, fear, or worry (obsession) that he or she tries to manage through a ritualized activity (compulsion) to reduce the anxiety.

Who is affected by Tourette’s disorder?

A diagnosis of TD is generally made before the child reaches his or her 18th birthday. In the majority of cases, a child is diagnosed around the age of 7. TD affects more males than females.

What are the symptoms of Tourette’s disorder?

Tic behaviors seen in TD change over time, and vary in frequency and complexity. The following are the most common tic behaviors associated with TD. However, each child experiences symptoms differently. Symptoms may include:

Involuntary, purposeless, motor movements (may involve different parts of the body, such as the face, neck, shoulders, trunk, or hands):
- Head jerking
- Squinting
- Blinking
- Shrugging
- Grimacing
- Nose-twitching
- Any excessively repeated movements (for example, foot tapping, leg jerking, or scratching)

Some of the more complex tic behaviors associated with TD may appear purposeful, and may include the following:

Kissing
Pinching
Sticking out the tongue or lip-smacking
Touching behaviors
Making obscene gestures

In addition to some, or all, of the above symptoms, TD is also characterized by one or more vocal tics (meaningless sound), in order for a diagnosis of TD to be made, including the following:

Grunting or moaning sounds
Barking
Tongue clicking
Sniffing
Hooting
Obscenities
Throat clearing, snorting, or coughing
Squeaking noises
Hissing
Spitting
Whistling
Gurgling
Echoing sounds or phrases repeatedly

Many children and adolescents who have TD also have attention problems and some also have academic difficulties. However, most have normal intelligence and do not usually have primary learning disabilities.

The symptoms of TD may resemble other conditions or medical problems. Always consult your child’s health care provider for a diagnosis.

Tourette syndrome – Symptoms and causes

Overview

Tourette (too-RET) syndrome is a disorder that involves repetitive movements or unwanted sounds (tics) that can’t be easily controlled. For instance, you might repeatedly blink your eyes, shrug your shoulders or blurt out unusual sounds or offensive words.

Tics typically show up between ages 2 and 15, with the average being around 6 years of age. Males are about three to four times more likely than females to develop Tourette syndrome.

Although there’s no cure for Tourette syndrome, treatments are available. Many people with Tourette syndrome don’t need treatment when symptoms aren’t troublesome. Tics often lessen or become controlled after the teen years.

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Symptoms

Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified as:

Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.

Tics can also involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.

Common motor tics seen in Tourette syndrome
Simple tics	Complex tics
Eye blinking	Touching or smelling objects
Head jerking	Repeating observed movements
Shoulder shrugging	Stepping in a certain pattern
Eye darting	Obscene gesturing
Nose twitching	Bending or twisting
Mouth movements	Hopping

Common vocal tics seen in Tourette syndrome
Simple tics	Complex tics
Grunting	Repeating one’s own words or phrases
Coughing	Repeating others’ words or phrases
Throat clearing	Using vulgar, obscene or swear words
Barking

In addition, tics can:

Vary in type, frequency and severity
Worsen if you’re ill, stressed, anxious, tired or excited
Occur during sleep
Change over time
Worsen in the early teenage years and improve during the transition into adulthood

Before the onset of motor or vocal tics, you’ll likely experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. Expression of the tic brings relief. With great effort, some people with Tourette syndrome can temporarily stop or hold back a tic.

When to see a doctor

See your child’s pediatrician if you notice your child displaying involuntary movements or sounds.

Not all tics indicate Tourette syndrome. Many children develop tics that go away on their own after a few weeks or months. But whenever a child shows unusual behavior, it’s important to identify the cause and rule out serious health problems.

Causes

The exact cause of Tourette syndrome isn’t known. It’s a complex disorder likely caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, might play a role.

Risk factors

Risk factors for Tourette syndrome include:

Family history. Having a family history of Tourette syndrome or other tic disorders might increase the risk of developing Tourette syndrome.
Sex. Males are about three to four times more likely than females to develop Tourette syndrome.

Complications

People with Tourette syndrome often lead healthy, active lives. However, Tourette syndrome frequently involves behavioral and social challenges that can harm your self-image.

Conditions often associated with Tourette syndrome include:

Attention-deficit/hyperactivity disorder (ADHD)
Obsessive-compulsive disorder (OCD)
Autism spectrum disorder
Learning disabilities
Sleep disorders
Depression
Anxiety disorders
Pain related to tics, especially headaches
Anger-management problems

Aug. 08, 2018

Tourette’s syndrome – NHS

Tourette’s syndrome is a condition that causes a person to make involuntary sounds and movements called tics.

It usually starts during childhood, but the tics and other symptoms usually improve after several years and sometimes go away completely.

There’s no cure for Tourette’s syndrome, but treatment can help manage symptoms.

People with Tourette’s syndrome may also have obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) or learning difficulties.

Symptoms of Tourette’s syndrome

Tics are the main symptom of Tourette’s syndrome. They usually appear in childhood between the ages of 2 and 14 (around 6 years is the average).

People with Tourette’s syndrome have a combination of physical and vocal tics.

Examples of physical tics include:

blinking
eye rolling
grimacing
shoulder shrugging
jerking of the head or limbs
jumping
twirling
touching objects and other people

Examples of vocal tics include:

grunting
throat clearing
whistling
coughing
tongue clicking
animal sounds
saying random words and phrases
repeating a sound, word or phrase
swearing

Swearing is rare and only affects about 1 in 10 people with Tourette’s syndrome.

Tics are not usually harmful to a person’s overall health, but physical tics, such as jerking of the head, can be painful.

Tics can be worse on some days than others.

They may be worse during periods of:

People with Tourette’s syndrome can have mood and behavioural problems, such as:

Children with Tourette’s syndrome may also be at risk of bullying because their tics might single them out.

Premonitory sensations

Most people with Tourette’s syndrome experience a strong urge before a tic, which has been compared to the feeling you get before needing to itch or sneeze.

These feelings are known as premonitory sensations. Premonitory sensations are only relieved after the tic has been carried out.

Examples of premonitory sensations include:

a burning feeling in the eyes before blinking
a dry or sore throat before grunting
an itchy joint or muscle before jerking

Controlling tics

Some people can control their tics for a short while in certain social situations, like in a classroom. It requires concentration, but gets easier with practise.

Controlling tics can be tiring. A person may have a sudden release of tics after a day trying to control them, like after returning home from school.

Tics may be less noticeable during activities involving a high level of concentration, such as reading an interesting book or playing sports.

When to get medical advice

You should contact a GP if you or your child start having tics.

Many children have tics for several months before growing out of them, so a tic does not necessarily mean your child has Tourette’s syndrome.

Diagnosing Tourette’s syndrome

There’s no single test for Tourette’s syndrome. Tests and scans, such as an MRI scan, may be used to rule out other conditions.

You can be diagnosed with Tourette’s syndrome if you’ve had several tics for at least a year.

Getting a firm diagnosis can help you and others understand your condition better, and give you access to the right kind of treatment and support.

To get a diagnosis, a GP may refer you to different specialists, such as a neurologist (a brain and nervous system specialist).

Treating Tourette’s syndrome

There’s no cure for Tourette’s syndrome and most children with tics do not need treatment for them.

Treatment may sometimes be recommended to help you control your tics.

Treatment is usually available on the NHS and can involve:

behavioural therapy
medicine

Behavioural therapy

Behavioural therapy is usually provided by a psychologist or a specially trained therapist.

2 types of behavioural therapy have been shown to reduce tics:

habit reversal training – this approach involves working out the feelings that trigger tics; the next stage is to find an alternative, less noticeable way of relieving the urge to tic
exposure with response prevention (ERP) – this method trains you to better control your urge to tic; techniques are used to recreate the urge to tic to train you to tolerate the feeling, without doing the tic, until the urge passes

Medicine

Some people’s tics are helped with medicines, but this is usually only recommended if the tics are more severe or affecting daily activities.

Medicines for Tourette’s syndrome can have side effects and they will not work for everyone.

Causes of Tourette’s syndrome

The cause of Tourette’s syndrome is unknown. It’s thought to be linked to a part of the brain that helps regulate body movements.

For unknown reasons, boys are more likely to be affected by Tourette’s syndrome than girls.

Further help and support

For more information about treatment and support, contact the charity Tourettes Action.

Video: Tourette’s syndrome

In this video, a neurologist talks about Tourette’s syndrome and what treatment and support is available.

Media last reviewed: 1 February 2021
Media review due: 1 February 2024

Page last reviewed: 04 January 2021
Next review due: 04 January 2024

Tourettes Disorder | Johns Hopkins Medicine

What is Tourette disorder in children?

Tourette disorder (TD) is a neurological disorder. It is also called Tourette syndrome (TS). The disorder causes repeated tics. Tics are sudden, uncontrolled vocal sounds or muscle jerks. Symptoms of TD often begin between ages 5 and 10. They usually start with mild, simple tics of the face, head, or arms. Over time, a child may have different kinds of tics that may happen more often. They may also involve more parts of the body, such as the trunk (torso) or legs. And they may be more disruptive to daily life.

What causes Tourette disorder in a child?

Most cases of Tourette disorder are caused by genes. It is an autosomal dominant disorder. Autosomal means that both boys and girls are affected. Dominant means that only 1 copy of the gene is needed to have the condition. A parent with TD or the gene for TD has a 1 in 2 chance to pass the gene on to each child.

In up to 1 in 20 children with TD, the disorder is not caused by genes. Possible causes in these cases may be problems during pregnancy, low birth weight, head injury, carbon monoxide poisoning, or inflammation of the brain (encephalitis).

Which children are at risk for Tourette disorder?

TD affects more boys than girls.

What are the symptoms of Tourette disorder in a child?

The most common symptoms are uncontrolled muscle movements. They may occur in the face, neck, shoulders, torso, or hands. Examples include:

Head jerking
Squinting
Blinking
Shrugging
Grimacing
Nose-twitching
Repeated foot tapping, leg jerking, scratching, or other movements

Complex tics include:

Kissing
Pinching
Sticking out the tongue or lip-smacking
Touching behaviors
Making rude gestures

TD also includes one or more vocal tics such as:

Grunting or moaning sounds
Barking
Tongue clicking
Sniffing
Hooting
Saying rude things
Throat clearing, snorting, or coughing
Squeaking noises
Hissing
Spitting
Whistling
Gurgling
Echoing sounds or phrases repeatedly

Tic behaviors change over time. They also vary in how often they occur.

TD can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD). This is an anxiety disorder. With OCD, a child has a repeated thought, fear, or worry (obsession) that he or she tries to manage through a certain behavior (compulsion) to reduce the anxiety.

Not everyone with the gene will have symptoms of Tourette disorder. If a parent passes the gene to a child, the child may not have any symptoms. If a daughter inherits the gene, there is a 7 in 10 chance that she will have at least one sign of TD. If a son inherits the gene, there is an almost sure chance (99%) chance that he will have at least one sign of TD.

The symptoms of TD can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is Tourette disorder diagnosed in a child?

A child with TD is usually diagnosed around the age of 7. A primary care provider, pediatrician, child psychiatrist, or a mental healthcare provider may diagnose your child. The healthcare provider will ask about:

Your child’s symptoms and health history
Your family’s health history
Developmental problems

The healthcare provider will also:

Watch your child’s behavior
Ask for a history of your child’s behavior from teachers
Assess your child’s psychological, social, and educational status

How is Tourette disorder treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Some children may not need treatment. A child with TD can usually function well at home and in a regular classroom.

In some cases, a child may need special classes, psychotherapy, or medicine. These may be choices if:

Tics cause problems with daily function or school
Your child has a problem such as OCD or attention deficit/hyperactivity disorder (ADHD)
Your child has another emotional or learning problem

A treatment called comprehensive behavioral intervention for tics can help children deal with tics and reduce tics.

Your child may need medicines if he or she has related conditions such as ADHD, OCD, or a mood disorder. Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are the possible complications of Tourette disorder in a child?

Many children who have TD also have attention problems. Some have trouble in school. But most have normal intelligence and don’t have a learning disability.

Other conditions commonly seen in children with TD include behavior problems, mood changes, social challenges, and trouble sleeping.

How can I help prevent Tourette disorder in my child?

Your healthcare provider may advise genetic counseling. You can discuss with a counselor the risk for Tourette disorder in a future pregnancy.

How can I help my child live with Tourette disorder?

Your child may need support and help with:

Self-esteem
Relationships with family and friends
Classroom participation

Talk with your child’s healthcare provider about the best ways to support your child.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

Symptoms that don’t get better, or get worse
New symptoms

Key points about Tourette disorder in children

Tourette disorder (TD) is a neurological disorder. It affects more boys than girls.
The disease causes repeated tics. These are sudden, uncontrolled vocal sounds or muscle jerks.
Symptoms of TD often begin between ages 5 and 10.
TD can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD).
Some children may not need treatment. A child with TD can usually function well at home and in a regular classroom. In some cases, a child may need special classes, psychotherapy, or medicine.
A family with a history of Tourette disorder should speak with a geneticist or a genetic counselor.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

What is Tourette Syndrome? | CDC

Tourette Syndrome (TS) is a condition of the nervous system. TS causes people to have “tics”.

Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person might keep blinking over and over. Or, a person might make a grunting sound unwillingly.

Having tics is a little bit like having hiccups. Even though you might not want to hiccup, your body does it anyway. Sometimes people can stop themselves from doing a certain tic for a while, but it’s hard. Eventually the person has to do the tic.

Types of Tics

There are two types of tics—motor and vocal:

Motor Tics

Motor tics are movements of the body. Examples of motor tics include blinking, shrugging the shoulders, or jerking an arm.

Vocal Tics

Vocal tics are sounds that a person makes with his or her voice. Examples of vocal tics include humming, clearing the throat, or yelling out a word or phrase.

Tics can be either simple or complex:

Simple Tics

Simple tics involve just a few parts of the body. Examples of simple tics include squinting the eyes or sniffing.

Complex Tics

Complex tics usually involve several different parts of the body and can have a pattern. An example of a complex tic is bobbing the head while jerking an arm, and then jumping up.

Symptoms of Tourette syndrome

The main symptoms of TS are tics. Symptoms usually begin when a child is 5 to 10 years of age. The first symptoms often are motor tics that occur in the head and neck area. Tics usually are worse during times that are stressful or exciting. They tend to improve when a person is calm or focused on an activity.

The types of tics and how often a person has tics changes a lot over time. Even though the symptoms might appear, disappear, and reappear, these conditions are considered chronic.

In most cases, tics decrease during adolescence and early adulthood, and sometimes disappear entirely. However, many people with TS experience tics into adulthood and, in some cases, tics can become worse during adulthood.¹

Although the media often portray people with TS as involuntarily shouting out swear words (called coprolalia) or constantly repeating the words of other people (called echolalia), these symptoms are rare, and are not required for a diagnosis of TS.

Diagnosing Tourette syndrome

There is no single test, like a blood test, to diagnose TS. Health professionals look at the person’s symptoms to diagnose TS and other tic disorders. The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or combination of the both), and how long the symptoms have lasted. TS can be diagnosed if a person has both motor and vocal tics, and has had tic symptoms for at least a year.

Learn more about how TS and other tic disorders are diagnosed »

Treatment for Tourette syndrome

Although there is no cure for TS, there are treatments available to help manage the tics. Many people with TS have tics that do not get in the way of their daily life and, therefore, do not need any treatment. However, medication and behavioral treatments are available if tics cause pain or injury; interfere with school, work, or social life; or cause stress.

Learn more about treatments »

Other Concerns and Conditions

Meet two families and hear about their experiences living with Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome

Watch the video »

TS often occurs with other conditions. Most children diagnosed with TS also have been diagnosed with at least one additional mental, behavioral, or developmental disorder such as attention-deficit/hyperactivity disorder (ADHD), anxiety, or obsessive-compulsive disorder (OCD). It is important to find out if a person with TS has any other conditions, and treat those conditions properly.

Learn more about other concerns and conditions »

Risk Factors and Causes

Doctors and scientists do not know the exact cause of TS. Research suggests that it is an inherited genetic condition. That means it is passed on from parent to child through genes.

Learn more about risk factors and causes »

Who Is Affected?

Studies that included children with diagnosed and undiagnosed TS have estimated that 1 of every 162 children have TS. In the United States, 1 of every 360 children 6 through 17 years of age have been diagnosed with TS, based on parent report.^3,4 This suggests that about half of children with TS are not diagnosed.

TS can affect people of all racial and ethnic groups. Boys are affected three to five times more often than girls.

More Information

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: , fifth edition: DSM-5. Washington, DC; 2013.
Bloch, MH, Leckman, JF. Clinical course of Tourette Syndrome. J Psychosom Res. 2009; 67(6): 497-501.
Centers for Disease Control and Prevention. Prevalence of diagnosed Tourette Syndrome in persons aged 6-17 years – United States, 2007. MMWRpdf icon Morb Mortal Wkly Rep. 2009; 58(21): 581-5.
Bitsko, RH, Holbrook, JR, Visser, SN, Mink, JW, Zinner, SH, Ghandour, RM, Blumberg, SJ (2014). A National Profile of Tourette Syndrome, 2011-2012. J Dev Behav Pediatr 35(5), 317-322.

Tourette | Kids Quest | CDC

What should you know?

Tourette syndrome is a condition of the nervous system. It causes people to have “tics”.

Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a kid might keep blinking over and over again. Or, a kid might make a grunting sound unwillingly.

Having tics is a little bit like having hiccups. Even though you might not want to hiccup, your body does it anyway. Sometimes people can stop themselves from doing a certain tic for awhile, but it’s hard. Eventually the person has to do the tic.

Just because someone has a tic does not mean they have Tourette syndrome. To get diagnosed with Tourette, you have to have both movement tics and voice tics, and you have to have some tic symptoms for at least 1 year.

Knowing the facts can help you understand what it is like to have Tourette.

Let’s learn more…

Follow the 8 steps below for your Web Quest.

Step 1: See what you know about people with Tourette. Take the Fact Checkup!

Step 2: Think about some questions you might have about Tourette. Let’s see…

Step 3: Check out some quick facts.

Step 4: Check out some great websites to help you learn more.

Step 5: Find out about people you can read about to help with your Quest.

Step 6: Learn about movies and books that can give you information.

Step 7: Check out your school and neighborhood.

Step 8: Now see if your attitudes have changed and if you know the right answers. Take the Fact Checkup again.

Let’s see…

What is Tourette syndrome, and why is it important for me to know about it?
What causes Tourette?
Can Tourette be cured?
What is it like having Tourette ?
Can kids with Tourette go to regular school?
Who are some famous people with Tourette ?

Can you think of more questions to help you in your Quest?
Click here to write them down so you’ll remember them as you move through this QUEST.

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Quick Facts

Here are some little known facts that can help you answer some of your Quest questions. Remember, these facts will give you only basic information. You’ll need to search the Web further to find more in-depth information for your Quest.

The symptoms of Tourette syndrome generally become less severe during the late teen years. Tic symptoms may disappear entirely in about 3 out of 10 people with Tourette as they reach their 20s.

During sleep, tics are fewer and less intense.

There are treatments for Tourette syndrome. One type is a treatment that teaches people with Tourette learn to manage their tics better. It’s called CBIT – Comprehensive Behavioral Intervention for Tics. It takes time, working with an expert who is trained in the CBIT, and lots of practice. It is not a cure for everybody, but it helps many people. Also, medication can help some people with their tic symptoms.

Most people with Tourette are able to hold jobs and lead full lives.

5 things you may not know about Tourette »

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Tourette’s syndrome: Symptoms, causes, and treatment

Tourette’s syndrome is a disorder that involves various physical tics and at least one vocal tic. A few people with Tourette’s unintentionally utter inappropriate or obscene words.

A tic is an unusual movement or sound that a person has little or no control over. It may include eye blinking, coughing, throat clearing, sniffing, facial movements, head movements, or limb movements, or making unusual sounds.

The tics are more common in people with obsessive-compulsive disorder (OCD), an autistic spectrum disorder (ASD), or attention deficit hyperactivity disorder (ADHD).

According to the Tourette Association of America, 1 in every 160 children in the United States may have Tourette’s syndrome. It is thought to affect 200,000 Americans, and it affects males more than females.

The condition has been linked to damage or abnormalities in the basal ganglia of the brain.

Here are some key points about Tourette’s syndrome. More detail is in the main article.

A person with Tourette’s syndrome will have physical and vocal tics lasting more than a year.
It is a neurological disorder with symptoms that are made worse by stress.
Treatment includes medication and behavioral therapy.
Tourette’s does not have serious complications, but it may be accompanied by other conditions, such as ADHD, and these can cause learning difficulties.

Share on PinterestSymptoms of Tourette’s include frequent blinking, shaking the head, or clearing the throat.

Tourette’s is one of a range of tic disorders that can involve transient or chronic tics. The tic can emerge at any age, but it most commonly appears between the ages of 6 and 18 years.

During adolescence and early adulthood, the tics will normally become less severe, but In 10 to 15 percent of cases, Tourette’s can become worse as the person moves into adulthood.

For most people, the frequency and intensity of both minor and major tics tend to fluctuate. Tics may become more frequent and more intense when a person is facing physical, emotional, or mental stress.

Most people with Tourette’s have normal intelligence and life expectancy.

The hallmark sign of Tourette’s syndrome is a tic. This can range from barely noticeable to severe enough to make daily life challenging.

A facial tic, such as eye blinking, may be the first sign, but each person is different.

A tic may be:

Physical: Motor movements include blinking or jerking the head or another part of the body.
Phonic: The person may utter sounds, such as grunts or squeaks, and words or phrases.

There are two main classifications:

Simple tic: This may involve moving just one muscle, or uttering a single sound. Movements are sudden, short lived, and often repetitive.
Complex tic: The physical movements are more complex, and the phonic tics may include long phrases. Complex tics involve several muscle groups.

People with Tourette’s have a combination of phonic and physical tics, which may be simple or complex.

Examples of simple physical tics may include:

eye blinking
eye darting
grinding the teeth
head jerking
neck twisting
nose twitching
rolling the eyes
rotating the shoulders
shoulder shrugging
sticking the tongue out

Examples of simple phonic tics may include:

barking sounds
blowing
clearing the throat
coughing
grunting
hiccupping
sniffing
squeaking
yelling and screaming

Examples of complex physical tics may include:

copropraxia, or making obscene gestures
echopraxia, or miming the movements of other people
flapping
head shaking
hitting things
jumping or hopping
kicking things
shaking
smelling objects
touching oneself or others

Examples of complex phonic tics include:

varying one’s voice intonation
echolalia, or repeating what other people say
paliphrasia, or saying the same phrase over and over again
coprolalia, which means uttering or shouting obscene words or phrases

Most people will experience unusual or uncomfortable sensations before the onset of a tic.

Types of advanced warning include:

a burning feeling in the eyes that is only alleviated by blinking
increasing tension in the muscles that can only be alleviated by stretching or twitching
a dry throat that is only alleviated by grunting or clearing the throat
itching in a limb or joint, where the only relief is achieved by twisting it

Situations that may cause tics to worsen include:

anxiety or stress
fatigue, or tiredness
illness, especially a streptococcal infection
excitement
a recent head injury

Medical News Today (MNT) asked the Tourette Association of America’s Medical Advisory Board what advice they would give to parents who think their child may have Tourette’s.

They told us:

“Tourette Syndrome is characterized by motor and vocal tics longer than 12 months. If this is the case, then start with a visit to the child’s primary care physician for an evaluation. Talk to him or her to see if the tics are causing pain or discomfort, bothering him or her, or affecting schoolwork or desired activities.

The Association provide resources and support for people with Tourette’s and for patents of children with the condition, including tools for parents and educators and information on how to find advocacy and support groups.

The exact cause of Tourette’s syndrome is unknown, but it appears to stem from a problem in the basal ganglia, the part of the brain that is responsible for involuntary movements, emotion, and learning.

Experts believe that abnormalities in the basal ganglia may cause an imbalance in levels of brain neurotransmitters, which transfer messages from one cell to another. Abnormal neurotransmitter levels may disrupt normal brain function, resulting in tics.

Parkinson’s disease, Huntington’s disease, and other neurologic conditions affect the basal ganglia.

Tourette’s syndrome is believed to have a genetic link and to be hereditary. A person who has a close family member with a tic is more likely to have one, too.

It also appears to be more common in infants who are born preterm.

Another theory is that a childhood illness may trigger tics. Infection with group A streptococcal bacteria has been linked with symptoms of Tourette’s. It may be that the bacteria cause the immune system to produce antibodies that interact with brain tissue, and this brings about changes in the brain.

This could have implications for treatment, but more research is necessary.

There is no current test for Tourette’s, so diagnosis depends on the signs and symptoms and medical and family history.

According to the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-5), published by the American Psychiatric Association (APA), the following criteria must be present for a diagnosis of Tourette’s:

The person has two or more motor tics, for example, blinking or shrugging the shoulders and at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
The person has had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on.
The person has tics that began before the age of 18 years.
The person has symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).

Other conditions that could produce similar symptoms include:

allergies, if there is coughing and sniffing
dystonia, a neurological condition that includes involuntary movements and prolonged muscle contraction, leading to twisting body motions, abnormal posture, and tremor
restless leg syndrome, if movements affect the legs
problems with vision, if the patient blinks a lot

Blood tests, a skin test, eye tests, and imaging tests can help rule out these and other medical conditions.

Treatment normally involves medication and non-pharmacological treatments. In rare cases, surgery may be an option.

Medication may include antihypertensives, muscle relaxants, or neuroleptics.

Antihypertensives are normally used to control high blood pressure, or hypertension, but they may help patients with mild to moderate symptoms of Tourette’s, possibly by regulating neurotransmitter levels. One example is Clonidine. Side effects include diarrhea or constipation, dry mouth, headaches, dizziness, and fatigue.

Muscle relaxants help control physical tics by treating spasticity, when muscles become too stiff. Examples include baclofen and clonazepam. Side effects include drowsiness and dizziness. Patients taking muscle relaxants should not consume alcohol, and they may not be able to drive or use heavy machinery.

Neuroleptics block the effects of dopamine in the brain. They may be taken orally or by injection. They can treat moderate to severe symptoms. Some slow-release neuroleptics are injected only once every 2 to 6 weeks.

Adverse effects may include drowsiness, blurred vision, dry mouth, low libido, shaking, spasms, twitches, and weight gain. Some neuroleptics have more adverse effects than others.

If side effects are becoming a problem, the patients should tell their doctor. There may be other neuroleptics they could take.

Non-pharmacological treatments

Behavioral therapy is commonly used to help people with Tourette’s. It can help change the patient’s behavior patterns.

Studies have found that comprehensive behavioral intervention for tics (CBIT), a kind of cognitive behavioral therapy (CBT) may help children and adults with Tourette’s syndrome. Therapy aims to treat symptoms by reversing habits.

Habit reversal is based on the idea that:

patients are unaware of their tics
the purpose of tics is to alleviate uncomfortable sensations before they occur

The therapist helps the patient monitor the pattern and frequency of their tics. Any sensations that are triggering the tics are also identified.

Once the patient is aware of the tic, they can develop an alternative and less noticeable way of relieving the uncomfortable sensations that are stirring. This is called a competing response.

For example, if an unpleasant sensation in the throat makes the person feel the need to grunt or clear their throat, they can learn to relieve the sensation by taking a series of deep breaths instead.

A study published in 2015 found that the kind of CBT used to reduce chronic tics in people with Tourette’s syndrome can also change the way their brains work.

Another study published in 2015 found that a brain chemical known as GABA may help treat tics in people with Tourette’s syndrome.

Habit reversal therapy often includes relaxation therapy. Stress or anxiety may make tics more severe and more frequent. Deep breathing and visualization may help relieve anxiety, often resulting in fewer and less severe tics.

Are there any alternative therapies?

Acupuncture and hypnosis have been proposed as possible therapies. A number of dietary factors have been suggested, such as a higher intake of vitamin B or vitamin D, but these have not been supported by research.

The Tourette Association Medical Advisory Board told MNT:

“There is no evidence at present for the use of any alternative therapies for the treatment of Tourette. Simply put, these have not been studied yet for Tourette.”

However, exercise and a healthful diet can help reduce stress and enhance a sense of wellbeing, which may help reduce the severity and frequency of tics.

Surgery

Surgery is usually only considered for adult patients with severe symptoms who have not responded well to other treatments.

Limbic leucotomy: An electric current or pulse of radiation is used to burn away a small part of the limbic system, which is responsible for some emotions, behavior and memory. This may resolve the problem partially or fully.

Deep brain stimulation (DBS): Electrodes are implanted permanently into parts of the brain known to be linked to Tourette’s. They are connected to small generators that are implanted inside the body. An electronic pulse passes from the generator to the electrodes, stimulating different parts of the brain. This may help control the symptoms of Tourette’s.

The long-term effects of DBS have not yet been proven.

Activities that may help include engaging in competitive sports, playing an enjoyable computer game, or reading an interesting book. However, overexcitement can be a trigger for some people, so some activities can have the opposite effect.

Many people learn how to control the tics when at work or school, for example, but suppressing tics may increase tension, until the tic can be expressed.

Over time, the types, frequency, and severity of tics may change. Tics tend to be most severe during the teenage years, but they often improve during early adulthood.

Tourette syndrome does not affect a person’s intelligence, but learning difficulties can result if the person also has ADHD, OCD, or ASD.

A child with or without these additional conditions may also experience bullying at school, and this can make schooling harder, both socially and academically.

Schools can help by educating students about the condition, so that they can better understand a classmate who happens to have Tourette’s.

The basal ganglia are also involved in habit learning, so people with Tourette’s may have problems with learning through habit. This may affect skills such as writing, reading, or arithmetic.

A child with Tourette syndrome may need additional educational help.

90,000 Treatment of Tourette’s syndrome in children

Tourette’s syndrome (Gilles de la Tourette) is a genetically determined disease of the central nervous system, the first manifestations of which occur in childhood.

It is generally accepted that this disease is mostly genetically determined. In the presence of a genetic predisposition, the development of pathology can be triggered by additional factors, such as unfavorable environmental conditions, a difficult perinatal period of development, smoking and alcoholism of the mother during pregnancy, the presence of streptococcal infection in the mother and child, difficult childbirth, low birth weight, oxygen starvation or brain injury at birth.

Each patient has a different manifestation of Tourette’s syndrome.

First of all, these are motor tics – involuntary movements of the whole body, sometimes twitching of the head or shoulder, grimaces, blinking, sniffing or blowing air out of the nose.

Voice, or vocal, tics are expressed in the pronunciation of strange sounds, sometimes inappropriate words, offensive phrases.

Motor tics often appear between the ages of 2 and 8 years. Voice tics most often begin to appear several years after the onset of motor tics, however, they can be observed in a child earlier, already at the age of 2 years.Symptoms of Tourette’s syndrome peak around age 12.

One of the specializations of the Matzpen center is the treatment of neurological disorders. And Tourette’s syndrome is no exception. The center’s specialists possess techniques that help teach patients how to cope with the symptoms of the disease, which allows them to continue to live a full life.

It is important to remember that the impact of a disease on a child’s life can be different. But in any case, Tourette’s syndrome requires the help of a specialist, i.e.j. even minor or infrequent manifestations of tics affect the child’s self-esteem, his relationships with others, friends, classmates and even with family members. In severe manifestations of Tourette’s syndrome, the child receives more severe psychological trauma, which interferes with his full development.

Tourette’s syndrome – what is this disease

Tourette’s syndrome is a genetic disorder that is most often passed from fathers to sons, much less often in women.At the same time, women whose fathers suffered from this ailment are highly prone to obsessive-compulsive disorder.

in a tenth of cases, Tourette’s syndrome is also accompanied by coprolalia – this is a painful craving for obscene language, a desire to use swear words when it is inappropriate. Coprolalia is not a symptom of this syndrome exclusively, because such a problem occurs in schizophrenia and in some manic states.

This is not to say that the disease itself is very rare – it occurs from 1 to 10 times in 2000 people, most often the diagnosis is made in childhood.

Factors provoking Tourette’s syndrome

Although the disease is genetic, some factors are more active in provoking it. Therefore, we highlight the following causes of Tourette’s syndrome:

90,030 90,031 serious infections;

poisoning by toxins;

90,031 mental trauma;

severe and repetitive stress;

90,031 use of psychotropic substances (including misuse of prescribed drugs).

How does Tourette’s syndrome

manifest itself

Symptoms of Tourette’s syndrome include:

various involuntary tics. Twitching is observed on the neck, face, in the shoulder area;
chaotic and frequent movements of the tongue, lips. Moreover, this can be accompanied by shouting out different words, sounds;
repetition of individual movements several times, repetition of syllables, words or sounds.

The list shows that the manifestations of the disease are motor (associated with movements) and vocal (associated with sounds). Everything related to movement most often manifests itself from 2 to 8 years old, and vocal “bursts” are typical for younger children.

Any tics with this disease are not controlled. These signs of Tourette’s syndrome exist as if by themselves – the patient is unable to cope with them. At the same time, in a stressful situation, such reactions become aggravated, become more pronounced, vivid and frequent.In conditions of complete rest and relaxation, tics are much less disturbing.

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Disease stages

The syndrome has four stages.They are determined depending on how often tics occur. If not more often than once a minute – we are talking about the first stage. Moreover, the patient often feels that the problem is approaching, and can somehow disguise it. In the second stage, 2 to 4 ticks per minute occur. This gives a strong stress to the psyche, it is overexcited.

Further, the process continues on an increasing basis: at the third stage, 5 or more ticks per minute are observed, and the fourth is characterized by very frequent ticks. In the latter case, serious mental disorders are not uncommon, since the central nervous system is under constant stress.

How does Tourette’s syndrome progress, is there a cure

It is impossible to completely cure the disease with the help of specific programs, but often it can disappear on its own. For example, this happens during puberty. If Tourette’s syndrome persists with age, it often duplicates various mental disorders such as panic attacks. This syndrome does not carry life-threatening consequences, however, it worsens the patient’s quality of life – if only for the reason that the patient feels uncomfortable, cannot communicate with others like an ordinary person.

Treatment of Tourette’s syndrome involves smoothing out severe symptoms, improving the patient’s quality of life.

Features of diagnostics

Diagnosis of Tourette’s syndrome consists of a set of measures:

This problem is dealt with by psychiatrists, and the syndrome itself belongs to psychiatric diseases according to ICD-10.

Important! Parents will not be able to determine for themselves what syndrome the child has. The fact is that there are very dangerous conditions that disguise themselves as tics, so visually they look the same as Tourette’s syndrome. But only a professional can make sure of this. If, during the examination, the specialist suspects a deviation, he may prescribe a number of additional examinations and analyzes (according to the situation). In this case, it is imperative to go through all the procedures and make sure that the diagnosis is accurate.

How is Tourette’s syndrome treated in Moscow

All methods that are used in the treatment of such diseases can be divided into medication and non-medication. The first involves taking sedatives, rarely tranquilizers. If they are prescribed, then in short courses and only after the doctor finds out that it is necessary.

Non-drug treatments for Tourette’s syndrome:

relaxing massage – manual and hardware;
reflexology. The option is chosen depending on the situation. This therapy is carried out with the help of hands, special needles, and electrical impulses. The point is to act on certain points of the body that will help to relax, stabilize the nervous system;
aromatherapy. It is aimed at rest, tranquility, relaxation.After consultation with a doctor, aromatherapy is also available at home – it is a simple and often effective method;
therapeutic sleep (electrosleep). Thanks to current impulses through special devices, such a dream normalizes the work of the brain and central nervous system. It usually lasts from 30 minutes to 2 hours;
psychotherapy. It helps a person get rid of anxiety, difficult conditions, psychological trauma, and also teaches them to accept their condition.

An important point in the treatment of Tourette’s syndrome is the right atmosphere at home, among close friends.A person with such a deviation should receive support, care, he must be protected from ridicule and inappropriate reactions to tics.

Traditional medicine

With such an ailment, you can use folk remedies that are aimed at stabilizing the condition, maintaining calm.These are teas and tinctures made from herbs such as mint, chamomile, lemon balm. You can use any soothing fees if you are not allergic to the components. However, you should not count on their healing properties – this is just an easy support of the condition in addition to the main treatment (be sure to consult with your doctor).

Tourette’s Syndrome FAQ

Answers to frequently asked questions:

Chudinskaya

Galina Nikolaevna

Experience 29 years

Neurologist

Do you have any questions? Leave a word and sign up for a consultation

Why is the syndrome called that?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association for Interdisciplinary Medicine

It got its name from Gilles de la Tourette.This physician published a major account of 9 patients with this syndrome in 1885.

Who is more likely to have Tourette’s syndrome?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association for Interdisciplinary Medicine

Symptoms of Tourette’s syndrome are more common in men – 3-4 times more often than in women (according to various sources).Also, the syndrome is more inherent in children – half of the patients get rid of it by the age of 18 (spontaneously).

How dangerous is Tourette’s syndrome?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association for Interdisciplinary Medicine

There is no direct danger to the life and health of the patient or others.It all boils down to the fact that, due to the awkwardness and difficulty in communication, the patient begins to withdraw into himself, to avoid people. Psychotherapy and competent treatment help to resolve this issue. Etc

90,000 “Joker” is harmful to parents whose children are diagnosed with Tourette’s syndrome “- neurologist Valery Zykov – Moskvich Mag

In Moscow, the prevalence of Tourette’s syndrome among children is one in a thousand. Valery Petrovich Zykov, head of the Department of Childhood Neurology at the Russian Medical Academy of Continuing Professional Education, member of the International Association of Pediatric Neurologists, told Olga Darfi about the treatment of Tourette’s syndrome in Russia and how important it is to change public opinion in relation to patients.

In one film at an antique auction, the hero got up, swore for a long time, called everyone present, and then showed a sign: “Never mind, I have Tourette’s syndrome.” And after the release of the film “Joker” now everyone knows that there is such a disease.

A terrible, very difficult film, why did I just watch it. And I didn’t get the impression that the hero has Tourette’s syndrome. I would call the film harmful to watch for parents whose children are diagnosed with Tourette’s syndrome – they will also live in stress, fearing such an outcome.According to our data, the pediatric form of Tourette’s syndrome is favorable in up to 30% of cases; after 15 years, the symptoms decrease to normal tics when overworked or in stressful situations with full social adaptation.

And involuntary loud laughter – isn’t it Tourette’s syndrome?

The Joker does not show the development of symptoms from childhood to adulthood. In addition to fits of sudden laughter, we see nothing, and this may be a mental illness. After all, how did it end there? They stopped giving the hero drugs, and he went into aggression up to murder, which is not typical for Tourette’s syndrome.We observe in patients vocalisms in the form of swearing – the medical term “coprolalia” – with amplification against the background of emotions, shouts occur in series. In adult patients, the vocal stage is possible, without motor tics. Vocalisms are often multiple: barking, grunting, shouting words, including swearing, repetitions of one’s own speech and the speech of others. In “Joker” the hero has severe behavioral disorders, and patients with ST tend to social adaptation.

Is it mandatory for Tourette’s syndrome?

Attacks of violent laughter are found in dementia, schizophrenia, hereditary degenerative diseases.The very first film showing Tourette’s syndrome is “The Old Man Hottabych”!

I don’t remember that at all!

Old man Hottabych punishes a child who deceived him with violent barking. Here’s a prime example of vocalism. Probably, the author of the work, Lazar Lagin, in his entourage observed such a patient.

How to accurately recognize Tourette’s syndrome?

These are multiple motor and vocal tics: blinking, screwing up your eyes, pinching your eyes, twitching your head, shoulders, squats and jumps.Patients sniff, grunt, can bark and shout out individual words, often curses. An important prerequisite for diagnosis is that they interfere with schooling and that adults interfere with professional activities.

Now the mother of one patient told me that she saw a man in the subway who jerked his shoulders, and then began to shout out words and, in order not to shout them out, thrust his hand into his mouth. In adults, coprolalia leads to maladjustment. And it all begins in childhood, at first there are involuntary blinking.

That is, this disease cannot begin in an adult?

No. Tourette’s syndrome begins before age 18. Tics have certain stages: the first stage of onset – at 3–7 years old, mainly motor tics, then the second stage comes – at 8–12 years old, the expression of symptoms with multiple motor and vocal manifestations. The third stage is residual – at the age of 13-15, tics decrease in severity. If tics are observed at the age of 18–20, then they will remain for life.Many people from the outside are frightened by the sudden sounds, grunting and barking of patients with Tourette’s syndrome. When coughing, children are taken to ENT doctors, sometimes they treat infections and allergies for six months before they turn to a neurologist. Therefore, knowledge of tics is useful for pediatricians, parents, and school teachers.

Are there many such patients in Moscow?

According to our population study in 2006, the prevalence of Tourette’s syndrome in Moscow is one in a thousand among children.Chronic tics – up to 1% of cases, and in Norway in 2019, four cases of patients with Tourette’s syndrome were registered per thousand children. This difference is likely related to the criteria for selecting patients for diagnosis.

Many people are frightened by the sudden sounds, grunting and barking of patients with Tourette’s syndrome.

In adults, more serious symptoms are noted: swearing and obscene gestures, this is exactly what scriptwriters in films like to exploit. You remembered “The Joker”, but obsessive laughter is not typical for Tourette’s syndrome, in childhood, over 30 years of observation, not a single case.Quite often, attention deficit disorder joins in – children perceive new information poorly, study poorly, cannot concentrate, respectively, cannot do some difficult work. Children are restless, quickly switch from one topic to another, do not bring the task to the end. They are characterized by aggression and anger, especially with an exacerbation of tics. This disease is not only neurological, it belongs to psychoneurology.

Where does this disease come from? Is it genetic?

Yes, more genetics data.CELSR3 genes associated with tics and Tourette’s syndrome have been identified, which control receptor proteins on the neuron membrane and their sensitivity to biological substrates, which will help develop new therapies in the future. But there are also psychogenic reasons – a reaction to some kind of severe stress. According to my observations, 40% of patients have relatives who have tics. Another interesting thing is that since there were tics in childhood, many adults forget what happened to them, and do not immediately remember at the visit.All this becomes clear after the second or third visit of parents with a sick child, or one of the relatives told them, or remembered that grandfather had strange phenomena, he coughed, blinked, but no one paid attention to it. There are genetic studies confirming that patients with Tourette’s syndrome are at high risk of addiction to games, drugs and alcohol.

Is there a prevention of this disease?

The issue of prevention for such patients is an individual education schedule so that the child is not overwhelmed, since any stress immediately provokes a worsening of the situation.Plus the prevention of gambling addiction – they must be distracted from games in all possible ways: sports, music, hobbies and walks. If after 15–20 years tics have not gone away, then there is a high risk that they will remain for life – after 20 years, the final maturation of the brain occurs. In half of patients, tics disappear by the age of 15, and after 20 years, 80% have regression of symptoms, only in 20% they remain in an adult state.

If these tics have not gone away, then that’s it, it is no longer possible to cure such a person?

In each case, we select an individual treatment.If a person screams so much that it interferes with everyone, they give him drugs, and if nothing helps, then some, only adults, after 21 years of age, are sent to neurosurgical centers for deep brain stimulation surgery, which can reduce tics and improve social adaptation, and in in some cases, refuse drugs. Of course, no one promises a complete cure, but the severity of tics is noticeably reduced.

Does this disease affect life expectancy?

I have not seen publications on the effect of Tourette’s syndrome on life expectancy.By the way, the influence of attention deficit disorder on mortality was studied in adults, it turned out that mortality is twice as high as in the population on average.

Is Tourette’s syndrome easy to diagnose? Do parents see tics in their child and immediately run to the doctor?

Yes, the diagnosis is purely clinical. To objectify tics and assess the prognosis, for the first time in Europe, we used computed electromyography on the basis of the 110th polyclinic of the Moscow DZ. But, of course, we do not put Tourette’s syndrome right away.I am a supporter of diagnosing after 15 years, but if a child has severe tics, we expose it at 10-12 years.

Was this syndrome diagnosed in Soviet times? How has treatment and approach changed since then?

I do not allocate such a time for neurology, let’s estimate the period over 30 years. Associate professor Yuri Ivanovich Malyshev was engaged in tics at our department, his memory is blessed, he used the term “generalized tic”, used neuroleptics for treatment. Neurologists have always been afraid to do this, because psychiatrists use neuroleptics.Malyshev laid the foundation for long-term treatment, I observed these patients for many years and really noted a pronounced clinical effect. We are the only neurological department dedicated to tics and Tourette’s syndrome, and we continue the tradition of long-term neuroleptic therapy.

What has changed over these 30 years? We have developed a classification of tics, introduced the term “Tourette’s syndrome” as it is used all over the world. New drugs were added to the treatment regimens: rispolept and topiramate.That is, new forms of drugs have appeared, but the approaches themselves have been preserved, this is a long-term long-term observation and treatment.

We involve parents in monitoring tics, they keep a diary of observations, count tics in 20 minutes at home, and we see the picture for a day, week, month and decide whether to prescribe drugs or not. That is, we went to analytics, introduced a technique for self-counting ticks by patients.

In America there is an association of patients with Tourette’s syndrome, its purpose is to unite those in need, to give advice online, by phone or in person.The association has lists of doctors who deal with the problem of tics, they spread information about this disease to schools for teachers and parents so that no one is afraid of such patients and does not tease them. And we have …

We involve parents in monitoring tics, they keep a diary of observations, count tics in 20 minutes at home, introduced a method of self-counting tics by patients.

Here parents tell me that the teacher shouted at the child, he developed tics, and now the teacher wants to get rid of him, transfer him to another class.The educator must understand that he can help the treatment by creating a comfortable environment for the child. Such an association has its own chat room, discussions are held there, and everyone can talk about their problems, get advice. They arrange picnics, meetings where such patients get together, they can grunt, swear and cough there, and no one looks at them askance. The association also informs about the latest drug treatment and behavioral therapy. After all, tics are treated with different methods, even osteopathy is offered, motivated by the fact that, they say, something has shifted and pinched there, the blood flow is not the same.

There is no such association in Russia, and its need has long been ripe not only for sick children and their parents, but also for adult patients. If parents can help a child cope with such a condition, then it is very difficult for an adult with such a syndrome to socialize, such patients sometimes simply limit themselves to theater visits, exhibitions and concerts. The Association of Patients with Tourette’s Syndrome must necessarily be in such a large country as Russia, you, as a journalist, can start organizing.I constantly talk with my parents at receptions about this, they answer: “Yes, yes,” but as the child gets better, they stop supporting this idea. If after this conversation one of the readers wants to take part in the creation of an association for tics and Tourette’s syndrome, please write to zykov_vpmail.ru.

Can the patient fight his screams himself? Although, it seems to me, this society should become more loyal and not strain because of such people.

Agree.We use behavioral therapy techniques for these patients. Here he, for example, coughs hysterically, and with the help of a specialist, he can find such movements that will help extinguish unwanted manifestations and change the tension of certain muscle groups. Rapid nasal breathing helps to contain the cry in a crowded place. For a certain period of time, the patient can, by an effort of will, extinguish the movements, but in the home environment, tics may not be restrained by the patient. It is also necessary to work with public opinion, there should be programs on TV on the problem of tics and Tourette’s syndrome, it is necessary to tell people about such patients, to develop tolerance.It is believed that Mozart had Tourette’s syndrome – while playing the piano, he developed tics, movements that frightened everyone, so Salieri was more often invited to musical salon evenings. In general, these patients in most cases receive education and are socially adapted, although this Joker of yours … a completely wrong interpretation of the disease, I just regretted that I watched such a movie at night. Yet a patient with Tourette’s syndrome is not a mentally ill person.

Photo: Olya Ivanova

90,000 Tics in children

If you find nervous tics in your children, be aware that according to statistics, about 25% of children experience similar manifestations.Moreover, boys are slightly more susceptible to this problem. Treatment of nervous tics is possible, and, as a rule, with a competent medical approach, it is possible to achieve significant results, reducing the manifestation of tics, and the onset of persistent remission.

What is tics in children, and how do they manifest

Nervous tics in children are manifested in the form of an involuntary contraction of a separate muscle group, more often their manifestation can be seen on the child’s face: the eyelid, lips, nose twitch, but this does not mean that other parts of the body are not susceptible to the manifestation of the disease.We just see the face more often and pay attention to the unusual movements of facial expressions. With young children, it is important to remember that the child may not be aware of his own tics, and even if he does, he has no way to suppress them. Asking a child with tics to try to suppress them is not a good idea. Efforts to suppress tics will distract the child from everything that is happening around. The forces expended on suppressing tics are often excessive, thereby causing stress, fatigue or irritability, and ultimately this can lead to the opposite effect – the manifestation of tics will become even more serious!

Tics in children: symptoms and treatment

The types of tic disorders can be categorized as follows:

Temporary tic disorder is the most common type.A significant part of all children, one way or another, is faced with the manifestation of tics during their development. In most children, tics appears without any reason or omen, the syndromes last for several weeks and then slowly disappear. These tics do not require professional treatment.
Chronic (persistent) tic disorder is less common. If the manifestation of tics has been noticed in a child for more than a year, then we can talk about a chronic course of the disease, in which one or more tics are noted.But it should be remembered that in this case, motor and verbal tics do not intersect. However, if we observe a picture with the simultaneous manifestation of motor and verbal tics, then we are already talking about a more serious disease.

A single manifestation of tics during nervous tension does not carry any threat – it happened and was forgotten. While tic disorder can significantly affect the standard of living, generate a number of unnecessary complexes in a child, thereby reducing his self-esteem.

Nervous tics in a child are also divided into motor tics when certain muscle groups are involved, most often these are repeated identical movements. For example, a child will grab the door handle several times before opening it, or a child has eye tics when the eyelid twitches. Motor tics are also divided into simple and complex, when a tic consists of several series of movements – these are complex motor tics. The second manifestation of nervous tics in a child is vocal tics, when the child involuntarily pronounces some sounds or repeats the same word several times in a row.Verbal tics can also be differentiated into simple and complex.

The reasons for the manifestation of nervous tics in children are not fully understood. There can be many factors here, such as nervous tension, usually characteristic of children and adolescents of school age, the use of certain medications. There are also deeper reasons for the manifestation of tic disorder, which indicates the presence of concomitant diseases. For example, “blepharospasm” can cause uncontrolled blinking.A disease such as “Tourette’s Syndrome” is also manifested by the presence of several tic disorders, not only motor, but also vocal. Fortunately, this disease is not so common, and it occurs in a few people out of 10,000. Tics is a fairly common disease that requires a comprehensive approach and extensive examination when choosing a treatment regimen for tics in children.

For a more complete picture of the anamnesis, it is necessary to inform the doctor the following data:

The age of the child when tic disorders were first noticed
Duration and severity of tics
Occurrence markers, if any, are seen (overexcitation, lack of sleep, etc.)etc.)
Are there hereditary factors

Treatment of tics in children

The nature of treatment for nerve tics can be divided into behavioral and drug therapy. Typically, behavioral therapy allows a child to learn how to manage their symptoms and then reduce their manifestations. The state becomes manageable. Parents of children with tic disorder play an important role in providing emotional support and treatment for the condition.Usually, with proper care, tics disappear after a few months, and a favorable prognosis for the future appears. Even after complete victory over the manifestation of tics, one should follow the recommendations prescribed by the doctor: observe the regime of study and rest, if possible, avoid acute stressful situations, be sure to get enough sleep.

For the future, and for the information of parents, I would like to list the factors that increase and, conversely, reduce the likelihood of tics in children and adolescents.

Increasing factors:

The child is nervous about school problems
Excessive psycho-emotional arousal can be caused by a variety of reasons: computer games, movies, etc.
Rest after school. As strange as it sounds, it is common that many children who try to suppress their tics at school (with varying degrees of success) are literally worn out by them when they come home.
Fatigue
Diseases (infections), the manifestation of allergic reactions, can provoke the awakening of tics
Suppressed tics (delayed response)
Talking about tics from others

Reducing factors:

The child is distracted or very involved in an activity
Responsible qualified assignments or tasks
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What is Tourette’s syndrome: symptoms, causes, video

With the development of medicine, many cases that were previously considered mysterious or even mystical are increasingly amenable to explanation. So it happened with Tourette’s syndrome. Such a disorder of the nervous system has already been described quite well, several options for its origin have been studied.This disease can manifest itself at any age and is characterized by motor tics and vocal responses.

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The disease was named after the French physician Gilles de la Tourette, who at the end of the 19th century described the symptoms of strange behavior in nine of his patients.

Nobody understood what was happening to these people and how to treat them. Patients from time to time involuntarily shouted words, and sometimes even obscene phrases, some also had pronounced tics. The unfortunate, against their will, could suddenly jump up, slap their hands or hit their head on the nearest surface. Tourette was interested in this pathology with clearly violent movements. It is not surprising that for a long time such a disease was simply considered an obsession, without trying to understand.

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Tourette’s Syndrome. What it is?

And although the syndrome acquired its name in the 19th century, there is no doubt that it met before. For the first time, a description of such a state can be found in the work of 1486 “Hammer of the Witches” about demons and witches. One of the stories tells of a priest with motor and vocal tics. Medieval authors simply found the man possessed.

Modern medicine looks at the syndrome more closely. A disease is considered a condition in which a patient can involuntarily perform certain actions. The first signs of the syndrome usually appear in early childhood. But such behavior, with shouting, clattering and swearing, is most often perceived by adults as banal bad behavior. And the rest of the child looks quite adequate and healthy to himself.

Modern medicine believes that such a neuropsychiatric disease can occur in one in a hundred thousand people.It is difficult to diagnose the syndrome, as it most often occurs in a mild form. But it is known that the disease occurs in men four times more often than in women. Unfortunately, the exact causes of the disease have not yet been identified, there are only a few hypotheses trying to explain the presence of the disease in a particular person.

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Videos of people with Tourette’s syndrome

Unusual, but at the same time pronounced and still occurring Tourette’s syndrome is gradually attracting attention.After all, now it becomes clear that some people with inappropriate behavior simply do not control themselves. It is worth looking at this situation differently and not blaming those who, even physiologically, are not able to stop swearing and twitching.

More and more people with this deviation can be found in films. And in the crime drama Orphan Brooklyn, the protagonist-detective is investigating, despite his Tourette’s syndrome.

Has this disease occurred in celebrities of the past? Rather yes than no. For example, it is believed that the behavior of Mozart contains features of such a syndrome as that of the poet Samuel Johnson. Of our contemporaries, we can note Billie Eilish, whose symptoms of Tourette’s syndrome have been repeatedly noted in the video.

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Why does Tourette’s syndrome appear?

There are several theories explaining the development of Tourette’s syndrome in humans.Among several reasons, the main one is considered to be genetic. Researchers have determined that if adults have involuntary tics, there is a 50% chance of having a similar disorder in children. Here are just a specific inherited gene has not been found.

The development of the syndrome is also associated with malfunctions of the immune system. It is believed that pathology can occur after a disease that has been caused by streptococcal bacteria. There may be reasons for hiding in disorders of the brain due to metabolic disorders or exposure to specific drugs.

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How is Tourette’s Syndrome treated?

There is no proven way to completely get rid of Tourette’s syndrome, doctors are only trying to help patients learn how to manage the most problematic symptoms. Most often, pharmacological treatment is not used, psychotherapy is much more effective.

In addition, it is already clear that the onset of an attack occurs in an atmosphere of stress and tension, without any external reason.A person wants to clear his throat, remove some debris from his eyes, relieve his tension with some movements. With the help of special practices, you can recognize the imminent onset of an attack, reduce its intensity.