Tourette syndrome is a neuropsychiatric disorder that can present with many clinical manifestations, with both vocal and muscular tics. Discover them here.
Tourette syndrome is a neuropsychiatric disorder characterized by the appearance of repetitive movements in early childhood. Its first manifestations begin before 18 years of age (between 2 and 15 years, usually at 6 on average), but, to consider a clinical case like this syndrome, they must remain for at least one year.
Historically, this pathology was considered a rare one, characterized by the emission of insults and bad words by the patient (coprolalia). Actually, this well-known symptom is only present in a small percentage of patients, as most clinical signs are simple tics such as blinking the eyes, shaking the head, shrugging the shoulders, moving the eyes suddenly, twisting the nose and making strange movements with the mouth. In addition to these, more complex symptoms may appear.
Between 0.4% and 3.8% of young children at any given place and time may suffer from Tourette syndrome, althoughmost cases are mild. If you want to know everything about the 4 types and manifestations that this pathology can show, continue reading.
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What is Tourette syndrome?
As we have said, Tourette’s syndrome is an inherited neuropsychiatric disorder, with onset in childhood, whichis defined by the appearance of physical (motor) and vocal (phonic) tics. These tics are preceded by a premonitory impulse (perceived by up to 90% of patients) and can increase or decrease in frequency over time.
The prevalence of Tourette syndrome at school ages worldwide is 1% of children. In addition, it presents a clear gender bias: it is much more common in men than in women, with a ratio of 3 to 1. Studies in the United States, based on population-based random sampling, estimate that 1 in 162 children (0.6%) have Tourettes. Of all children diagnosed, approximately 37% claim to have suffered moderate or severe forms of the disease.
Despite these statistics, it is believed thatup to half of infants with this condition are never diagnosed. This is because, in part, some people are able to suppress, minimize or camouflage their tics, in order not to suffer serious social impediments and stigmatization by the general population. This is not positive in the long term: the masking of this mismatch prevents its correct approach and treatment.
What types of Tourette syndrome are there?
When asking this question, it is necessary to take into account that it does not distinguish between “types” of Tourette to use, but the pathology is classified based on the tics that are presented. It should be noted that this typology is not exclusive and that, in addition, the symptoms in each category can be more or less severe based on the condition of each patient. Let’s get to it.
1. Simple motor tics
They usually appear in milder forms andusually only affect one muscle group, such as the muscles responsible for closing the eyes. They are sudden, mild, brief and repetitive tics. Among them we find eye blinks, shrugging the shoulders, shaking the head, twisting the nose, moving the eyes quickly and making strange movements with the mouth.
2. Complex motor tics
Theseinvolve several muscle groups and can have a specific pattern, so they are defined as “a process characterized by a series of consecutive movements.” For example, a person can touch parts of his body in ascending order during the tic, always in the same way, as if it were a kind of ritualization.
Complex motor tics include touching or smelling objects, repeating observed movements, making obscene gestures (rarely), leaning over, jumping suddenly, and walking in a certain pattern. Complex tics involve a more severe variant of the disorder.
3. Simple vocal tics
Vocal tics, as the name suggests, are sounds that the patient emits with his own voice. These are usually accompanied by simple motor variants, and usually consist of grunts, clearings, screams and barking. For an effective diagnosis to be made, vocal tics must present with some type of muscular manifestation, however slight.
4. Complex vocal tics
We enter what is commonly known as Tourette in general society, although reallyonly a small percentage of patients present this typology. Complex vocal tics involve socially unpleasant acts, such as issuing insults (coprolalia), making obscene gestures (copropraxia), or repeating phrases that someone else has uttered as an echo (echolalia).
Copropraxia is present in 3% to 21% of patients, so in the most affected sample groups, just over a fifth of them utter obscene words without any sense. Echolalia is a little more common, as it is practiced by 11% to 44% of people with Tourette. In any case, these statistical data show that the social idea of this condition does not correspond to reality: coprolalia and copropraxia are not common manifestations in the form of vocal tics.
Progression of Tourette syndrome
As indicated by medical sources, the first symptoms of this condition begin between 7 and 10 years of age in general. The first usual clinical sign is the appearance of facial tics, to which muscle spasms can be added at the level of the neck, trunk and extremities.
Most patients experience a pathological peak at the entrance of adolescenceand improve as they progress through this stage and enter adulthood. In any case, 10-15% of those affected will have severe symptoms that will cause social dysfunction on various fronts of great importance. There is no absolute treatment to treat Tourette syndrome, but symptoms can be controlled and mastered with proper therapy. Pimozide, an antipsychotic drug, may also be prescribed in certain patients with this pathology.
Can people with Tourettes avoid their tics?
You may be wondering at this point if it is possible to suppress the symptoms of this condition. You should keep in mind that tics, come in whatever form they come, are involuntary, although they can be triggered by social factors. Sometimes tics seem intentional, as they appear at “opportune times,” but this is never the case.
However, some people may repress and disguise the spasms to avoid social confrontations. This is counterproductive in the short term: individuals who suppress their tics experience an exponential increase in their tension and anxiety, which translates into a greater likelihood of manifesting them.
Possible causes of Tourette syndrome
Although the causes of this problematic conditionare not fully known, we see interest in listing some of the possible suspects. Among them, we find the following:
- Genetic factors: A person descended from a patient with Tourette has a 50% chance of inheriting the condition.
- Streptococcal infection: Oddly enough, some theories indicate that a severe strep infection can cause the neurological imbalances necessary for the syndrome to appear.
- Neurochemical abnormalities: Neurotransmitters appear to be metabolized differently in these patients.
- Other disorders: Up to 90% of cases appear disorders associated with the condition. ADHD and dyslexia are some of the most common.
Despite the discordances presented in consulted portals, it seems that there is consensus that this syndrome may appear as a combination of genetic and environmental factors. We will have to wait for neuroscience to advance until we find an exact etiology.
Summary
As you have seen, Tourette syndrome remains a widely unknown pathology in the world of medicine and neuroscience. It is known how it is expressed and based on it is cataloged, but the causative agents are still not at all clear. While some people with this condition can lead a practically normal life from adulthood, a small percentage of them will have disabling signs for the rest of their lives.
If we want to emphasize one point of all the terms exposed, it is that Tourette syndrome is much more than a person making obscene gestures or insulting someone. Complex vocal tics are established in the collective imagination as the main characteristic of the disease, but the reality is that they occur only in a small percentage of patients. Even if you meet someone who suffers from these impulses, remember that they are not voluntary and that surely he is having just as bad a time as you at the time of the interaction.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
