Tourette Syndrome

What is it?.....

Tourette syndrome (also known as TS) is a neurological disorder which causes the person to have both vocal and motor tics. Tics happen without the person realizing it. They are sudden, uncontrollable, repetitive movements or sounds. An example of a motor tic would be: exaggerated blinking of the eyes. While an example of a vocal tic would be: throat clearing or grunting. The disorder is named after the the pioneering French neurologist, Dr. Georges Gilles de la Tourette. In 1885 Dr. Tourette first diagnosed the condition in an 86-year-old French noblewoman.

What are the possible causes?

  • Doctors and researchers do not know the exact causes of TS, but some researchers believe it has something to do with the balance of communication between the nerves within the brain.
  • Neurotransmitters are chemicals located in the brain that carry nerve signals from cell to cell. If there is any possible imbalance of these chemicals then the ending result could be TS.
  • TS is 100% not contagious. It is actually a genetic disorder, which means the persons genes change due to inheritance from the parent or during the development inside the womb.

Symptoms of TS

  • TS can affect all ethnic group and symptoms start at an early age, around the ages of 3 and 9 years.
  • The main symptom first recognized are the tics. When a person is under stress the tics can become more severe. Tics include: head jerking, stomping, eye blinking, making clicking sounds, repeated sniffing, yelping, shouting, and many more.
  • A lot of people who have heard of Tourette syndrome usually thinks the person with TS will swear or use inappropriate expressions. But that is actually one of the less common symptoms.
  • In addition to tics, many people who suffer from TS may have a handful of other conditions. For example they may have attention deficit hyperactivity disorder (ADHD), or obsessive compulsive disorder (OCD).
  • Every person who is diagnosed with TS has different symptoms, their tics can vary in frequency and type.
  • The patient must of had motor or vocal tics for at least 1 year before a doctor diagnoses them with TS. Diagnosis may take a while because the symptoms may mimic those form other disorders.

There is no cure, but TS can be treated....

Medications can be used to help control or minimize tics, or help with related disorders: ADHD and OCD.

  • Botulinum toxin type A (Botox) injections- an injection into the affected muscle may help relieve simple or vocal tics.
  • Stimulant medications- used to help increase attention and concentration for people with ADHD. Include; Methylphenidate, Concerta, Ritalin,  Adderall XR, and Dexedrine.
  • Drugs that block or deplete the neurotransmitter dopamine in the brain- Used to control tics, but these medications may have side effects such as weight gain and a dulling of the mind. Include; fluphenazine, haloperidol (Haldol) or pimozide (Orap).
  • Antidepressants- may help control symptoms of sadness, anxiety and OCD. Such as; fluoxetine (Prozac and Sarafem).
  • Central adrenergic inhibitors- may help control behavioral symptoms, such as impulse control problems and rage attacks. These drugs are typically for high blood pressure and may have a side affect of sleepiness. Includes; clonidine (Catapres) or guanfacine (Tenex).

Therapies can also be used to treat TS.

  • Behavior therapy- to reduce tics a behavior therapy called habit reversal training may be used. This treatment helps you monitor the urges you may feel right before getting a tic. Then form learning about the urges you can respond to them by moving in a way that is incompatible to the oncoming tic.
  • Psychotherapy- can help with accompanying problems, such as ADHD, obsessions, depression or anxiety. This therapy is more of a talk therapy.
  • Deep brain stimulation- used for severe tics that do not respond to other treatments. A battery-operated medical device (neurostimulator), is implanted into the brain to deliver electrical stimulation to targeted areas that control movement.

Learning strategies

  1. The first thing you want to do as a teacher is make sure the learning environment is comfortable for a child with Tourette syndrome. A child with Tourette's have the same IQ range as the general population. But, they may not be comfortable with their tics and may need permission to leave the room if tics get too out of control. Because TS affects a child's attention span other tools like tape recorders, computers or typewriters may be used to help the child. When testing, children with vocal tics can be seated in a private room where their test is untimed.
  2. A lot of Patience is required when having a child with TS in the classroom. Tics can be loud and disruptive and may annoy the class, but you must remember it is involuntary. If you do not have patience with the child, classmates will not either and may ridicule them.
  3. Provide opportunities for short breaks outside of the classroom. Private time can help relax the child and prevent tics. Private time can also improve the child's ability to focus.
  4. If some tics are disruptive limit assignments for the child to recite in front of the class. oral reports could be tape-recorded.
  5. Last, it is important to work with other students so they know what Tourettes syndrome is and what tics are. Psychologists, school counselors, and even representatives from the local Tourette Syndrome Association chapter can provide information and appropriate audio-visual materials for students and staff.

Just a couple of Statistics:

  • It is estimated that 200,000 Americans have the most severe form of TS, as many 1 in 100 exhibit milder cases of TS.
  • Males are affected bout 3 to 4 times more often than females.
  • Individuals are twice as likely to be diagnosed with Tourette’s Syndrome between the ages of 11 to 17 as you are between the ages of 6 to 10.
  • More then 1/3 of all people with Tourette’s Syndrome have obsessive compulsive disorders also.
  • Tourette’s Syndrome less common than many other conditions that children may have.

                                          

Family and community resources!

For lots of information on help you can receive for TS, go the national Tourette Syndrome Association homepage. There you will fin lots of different organizations and their contact information.

Local Resources

The Johns Hopkins Hospital Children's Center
David M. Rubenstein Child Health Building
Room 2158
200 N. Wolfe Street
Baltimore, MD 21287

410-955-4259

https://www.hopkinschildrens.org

The Parents' Place of Maryland

801 Cromwell Park Drive, Suite 103
Glen Burnie, MD 21061

410-768-9100

info@ppmd.org

Tourette Syndrome Association of Greater Washington                                         33 University Boulevard, East
Silver Spring, MD 20901
(301) 681-4133; (877) 295-2148; (301) 681-4183 (fax)
Email: tsagw | at | aol.com
Web: http://www.tsagw.org/
Serving Virginia, Maryland, West Virginia and Washington, D.C.

References

Diagnostic categories(1998). Teaching Children With Tourette Syndrome. Bernadette Knoblauch. Retrieved from www.kidsneeds.com

National Institute of Neurological Disorders and stroke(2014). Tourette Syndrome Fact Sheet. Retrieved from www.ninds.nih.gov/

Teens Health(2005). Tourette Syndrome. Retrieved from http://kidshealth.org

          

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