Literatus: Tourette

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Tuesday, May 6, 2014

STARTING May 15, the world will be celebrating the Tourette Syndrome Awareness Month.

Breakthroughs supports this move with a special discussion of this inherited neuropsychiatric disorder.

Tourette usually starts to manifest in childhood (mostly between ages five and seven) with its characteristic multiple physical tics and at least one vocal tic.


Tics, according to the Leckman study published in Advanced Neurology (2006), are sudden, repetitive, non-rhythmic movements (e.g. throat clearing, eye blinking, and shoulder shrug) and utterances (e.g. involuntary shouting) that involve discrete muscles.

Although considered before as rare, studies through the years noted a prevalence of 0.4 percent to 3.8 percent usually among children ageing five to 18. Most patients experience peak symptoms before their mid-teen years, with majority improving in their late teens and early adulthood.

Around 10-15 percent, however, progress to disabling severity into adulthood. So far males get Tourette around three to four times more than females. Still only children who inherited the genes show symptoms that require medical intervention.

The exact cause of Tourette remains unknown. Even laboratory diagnosis is good only at ruling other diseases, not pointing on its presence.

Researchers though confirmed the involvement of genetic and environmental factors. Detecting the symptoms also remains problematic because families as well as physicians unfamiliar with the syndrome consider the mild and even moderate symptoms as inconsequential. That explains why many patients self-diagnose their condition.

Neurologists diagnose Tourette by the presence of both motor and vocal tics for at least 12 months. Simple tics include eye-blinking, facial grimacing, shoulder shrugging, head or shoulder jerking, repetitive throat-clearing, sniffing, grunting sounds, and barking. Complex tics include facial grimacing with a head twist and a shoulder shrug, sniffing or touching objects, hopping, jumping, bending, twisting and punching self in the face, all done with sudden, brief movements.

The Nagai study, published in Cognitive Behavioral Neurology (2014), noted the ineffectiveness of biofeedback training in controlling Tourette symptoms.

If you want to see these symptoms, try watching the movie Front of the Class (released in 2008), starring James Wolk. Everton goalkeeper Tim Howard reminds: “Tourette’s syndrome is not a problem… It doesn’t affect me one way or another on or off the field.”


Published in the Sun.Star Cebu newspaper on May 07, 2014.


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