Dear Reader,

Sounds as though you're talking about Tourette's syndrome (TS), a genetic, neurological condition that was named after the French neuropsychiatrist, Dr. Georges Gilles de la Tourette, who evaluated a number of cases of TS in 1885. Affecting around 1 in 600 people, folks with TS usually begin having what seem to be involuntary movements and vocalizations during childhood that are called tics. These symptoms are classified into two groups:

Simple tics are sudden, brief movements that only involve a few muscle groups. They're often repetitive (done over and over again), and include:

• blinking of the eyes
• shrugging of the shoulders
• making faces
• yelping or other sounds
• sniffing
• jerking of the head
• stretching the neck

Complex tics are more involved activities that require the coordinated effort of several muscle groups. They include:

• jumping
• contacting the nose or other folks or objects
• smelling things
• echolalia — repeating what other people say
• coprolalia — use of foul language, curses, or ethnic slurs. Although this is the most widely known symptom, coprolalia occurs in less than fifteen percent of people with TS.
• self-injurious behaviors, such as lip and cheek biting, head banging, or hitting oneself. These are extremely rare and associated with the most severe forms of TS.

Tics are not completely uncontrollable. Some people with TS are able to suppress tics for a short time (similar to holding back a cough), but eventually, the tension mounts and the tic is expressed. Stressful situations tend to make tics occur more often, while states of relaxation or deep concentration have the opposite effect. As folks with TS reach adulthood, tics tend to decrease in frequency; some adults even experience complete remission of symptoms.

TS is believed to be inherited through a dominant gene or genes. This means that a person with TS has a 50-50 chance of passing on the trait to any children s/he has. People with the gene(s) for TS may display various ranges of severity of symptoms. Some experience only mild tics or obsessive compulsive behaviors; others are carriers of the gene(s), meaning they experience no symptoms at all. Men with the TS gene(s) are three to four times more likely than women with the TS gene(s) to exhibit signs.

Although no specific treatments for TS are available, most people with TS are able to function well and lead productive lives without medication. Those who have severe tics that are disruptive or dangerous can benefit from medicine to help control their symptoms. Currently, researchers are trying to identify the gene(s) linked to TS to better understand how the syndrome is inherited and expressed, and to find more effective therapies.

According to the National Institutes of Health's National Institute of Neurological Disorders and Stroke, the cause of TS is unknown, but research points to a problem in the brain's metabolism of dopamine and other neurotransmitters (chemicals that relay messages between nerve cells in the brain). Because the exact cause is still a mystery, there's no test for TS. Instead, diagnosis is made when a person has experienced both motor and verbal tics for at least a year. Children with TS are often misdiagnosed with behavioral or psychological problems because of the disruptive nature of the tics and a lack of general knowledge about TS. Incorrect diagnosis and public misunderstanding of the syndrome often cause people with TS to feel ashamed and socially isolated. The Tourette Syndrome Association offers support groups and other resources for people with TS and their families.

Alice

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