Tourette Syndrome in Children
What is Tourette Syndrome?
Tourette Syndrome (TS) is an inherited neurological disorder generally associated with tics. Tics are defined as either involuntary body movements, or involuntary vocal sounds that are usually repetitive. The occurrence of TS in children is about 1 of every 2000 children, with an increased occurrence in boys as opposed to girls. The syndrome itself is named for the French neurologist Dr. George Gilles de la Tourette, who diagnosed the first patient with the illness in 1885.
How do you know if you have it? (Symptoms and Diagnosis)
Diagnosis specifics vary from one source of information to the next. Some publications, such as the website for the Jim Eisenreich Foundation for Children, suggest waiting until the tics are present for at least one year, and that multiple tics must be shown - vocal and physical (though not at the same time). Other sites claim that the tics usually don't really surface until the children are around five or six years old, but always before they are twenty-one. The occurrence of TS is increased if the child has a parent or sibling with TS. In many instances, the tics seem to disappear completely when the patient is in his or her twenties, but some patients are forced to live with TS for the rest of their lives. TS is often misdiagnosed because so little is really known about the disease. It is a clinical disease, meaning that there are no blood tests that can be done to prove that someone has it. The uncertainty surrounding the disease causes a lot of children with TS to have a hard struggle at school, with personal relationships, and can cause them to become the target of ridicule. Children, of course, are scared of what they don't understand, and TS is not something that has always been openly talked about. Some of the preconceived notions about people with TS are ridiculous - even that they are demon possessed and that is why they scream out obscenities! In truth, the act of screaming out obscenities (coprolalia) occurs less than 15% of the time in those with TS. The media coverage of TS just seems to highlight the cases in which the children repeat things that are inappropriate.
One specific research study focused on the occurrence of TS associated tics in primary school children. This study was published in the Journal of the American Academy of Child and Adolescent Psychiatry. The same doctor saw a general population of primary school aged children in Sweden in a clinical setting. The findings regarding rates of occurrence were alarming - for boys, the rate of occurrence was 1.7% with girls being about 0.5%. Overall the rate was 1.1% for their general population sample. The ratio of TS occurrence in boys vs. girls was anywhere from 4:1 to 6:1. The rate of comorbid conditions (conditions that accompany the initial disorder) was very high in this sample group. About 64% suffered from ADD (ADHD), 47% from coprolalia or inappropriate sexual behavior, 36% had some sort of learning disability (dyslexia, for example), 17% had undefined behavioral problems and 24% had development / coordination problems.
The researchers were also able to speak with the teachers of these students, which gave some insight on the types of other difficulties these children were faced with. For example, 21% were commonly involved in conflicts with other students. A mere 14% had reported no interaction problems. A lot of the students were also described as seemingly having one or no friends at all, though the doctors did not actually present any percentage information on this because of the actual reliability of the information.(Bjorn, 552)
The tics are usually mild in severity though some can be severe and all are completely uncontrollable.
Tics can either be simple or complex. "Simple tics are sudden, brief movements that involve a limited number of muscle groups," while complex tics can be described as "distinct, coordinated patterns of successive movements involving several muscle groups." (Whitley) Some examples of simple tics are eye-blinking, movement of shoulders (like shrugging), facial contortion, barking, etc. Complex tics can include touching facial features (nose, eyelids), touching people around you, jumping, and smelling things.
There are current studies that are researching the actual basis for TS, but no known cause has been determined as of yet. At this time, researchers seem to think that the problem lies within the brain's metabolism of chemicals that are responsible for carrying signals between brain cells - commonly known as neurotransmitters.
Section Two: How do you treat TS?
The treatment for TS varies depending on the severity of the...
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