Tourette Syndrome and Tics: what are the symptoms and the most effective treatments?
Tics are involuntary, sudden, rapid, recurrent, and stereotyped gestures, movements, or vocal expressions, which can be classified as simple or complex.
Tourette Syndrome (TS) is diagnosed when individuals exhibit both motor and vocal tics for over a year.
Tics are involuntary, sudden, rapid, recurrent, and stereotyped gestures, movements, or vocal expressions, which can be classified as simple or complex. Tourette Syndrome (TS) is diagnosed when individuals exhibit both motor and vocal tics for over a year.
Simple tics involve only one or a few muscles, with common examples including eye blinking, facial twitches, and throat clearing. Complex tics, on the other hand, manifest as coordinated limb or head gestures or the repetition of words or phrases, sometimes vulgar (coprolalia).
Some people may experience “Tic attacks” that are episodes of intense, persistent tics that can last anywhere from a few minutes to several hours. These episodes often involve full-body writhing, muscle tensing, and shaking. Tic attacks can cause significant anxiety for both the individual and their families.
These manifestations occur almost unconsciously, without a specific purpose; however, tics are typically preceded by a premonitory urge or a tension feeling.
What could be the co-occurring features and conditions?
Tics can also occur when a Neurodevelopmental condition is present, like Autism or ADHD, or can be associated with obsessive-compulsive disorder, mood disorders, conditions, like encephalitis, Huntington's disease, primary dystonia, neuroacanthocytosis, Hallervorden-Spatz disease, strokes, and head trauma. Occasionally, they may be induced by toxins, drugs, or certain medications.
Why do I tic?
Tics typically begin in childhood around the age of four to seven years, and their symptoms often fluctuate in terms of severity and frequency. During childhood, nervous tics in children can be quite common, affecting approximately 10-15% of kids.
Tourette Syndrome is observed in 3-8 per 1,000 children. Symptoms may peak in severity between age 10- and 12 years-old, but often, most tics disappear or diminish during adolescence with spontaneous remission around 18-20 years-old, requiring no treatment. The onset of tic disorders in adulthood is rare and may be linked to damage to the central nervous system or drug use.
No single gene has been identified as the sole cause of Tourette Syndrome, and its exact cause remains largely unclear. Research suggests the involvement of a possible imbalance in the brain's neurotransmitters, especially dopamine and serotonin. It is also known that various environmental factors may influence the onset or severity of Tourette Syndrome, such as complications during pregnancy and low birth weight in premature infants. Stress, high emotions, anxiety, and fatigue can exacerbate tics.
Some people with Tourette Syndrome continue showing Tics throughout their life, even though these will often “wax and wane”, which means they may subside for a while and then resurface.
Do I need treatment?
This depends on the person’s choice and severity of the symptoms. If Tics are mild and the person does not feel affected by them, Tics may not need to be treated. However, there are children or adults who suffer from more severe forms of Tics or Tourette Syndrome, may struggle to maintain optimal self-esteem and face difficulties in relationships. For example, children may be teased by peers at school, leading to anxiety or depressive symptoms. Not all teachers are equipped to recognize these difficulties and therefore may not adequately support the student.
Medication to halt tics is recommended only in cases of persistence and interference with the child's activities or self-image. The lowest effective dosage is used to make the tics tolerable, which is then gradually reduced with decreasing tic severity.
Some of our therapists at Mindscape are trained in CBIT (Comprehensive Behavioural Intervention for Tics), the most effective behavioural intervention for managing tic manifestations and Tourette’s. CBIT includes cognitive-behavioural techniques (such as counterconditioning) to help develop new behaviours that replace tics, education on tic identification in triggering situations, and relaxation techniques.
If professional support is needed, you can schedule a free 10-minute consultation to learn how Mindscape clinicians can help. Alternatively, you can fill out the form with your preferred call time and contact number, and a team member will contact you within 48 hours.
https://www.tourettes-action.org.uk
