Tourette is a neurodevelopmental syndrome and its main symptom is tics. This is the syndrome of tics which are recurrent involuntary and sudden movements of muscles which may seem inappropriate. The tourette patient may also produce weird sounds respectively. The repetition of tics cannot be control because in tourette different parts of brain which interlinked with each other show poor performance which is responsible for defected muscle movement and vocals uncontrollability. The variation in the intensity of tic may appear from milder to chronic complex tics. The symptoms must be appeared before the age of 18 and present for at least one year persistently since the first inception. Premature babies are more likely to develop tourette in between the age of 6 to 18 years.
According to DSM-5 tourette syndrome diagnostic criteria is that multiple motor complexity and one or more vocal tics have to occur simultaneously but not concurrently. The other criteria is that symptoms must be present without any other medical reason or drug use.
Tourette syndrome develop due to the disturbance in central nervous system. When dysfunction occurs in certain part of brain which disturbs the regulation of neurotransmitters then signals from brain to muscles got interrupted which cause tics. The defect occurs in three parts of brain Thalamus, Basal Ganglia and Frontal Cortex which disturb the regulation of dopamine, serotonin, gamma-aminobutyric acid (GABA), glutamate and histamine. The thalamus regulates sensory signals to cerebral cortex. Basal ganglia interconnect with thalamus, cerebral cortex and brainstem. Any defect in basal ganglia cause problem in controlling speech, movements and postures while frontal cortex responsible for social and sexual behavior.
As the syndrome is related to neurological disturbance hence it can be worsen due to any kind of stress i.e. physical, mental or emotional. Tics can also be increases due to excitement, excessive tiredness or sickness. However, the tourette is consider to be inherited rather than cause by any environmental factor. Researches have revealed that the syndrome effects males more than females.
Tourette syndrome is classified on the basis of tics such as simple motor tics, complex motor tics, simple vocal tics and complex vocal tics. In general, tics are of two types simple and complex.
Simple motor tics can be identified with highly short duration of milliseconds. It may include eye blinking, shrugging and shoulder movements, limb and head jerking, grimacing and abdominal tensing while simple vocal tics are throat clearing, sniffing, whistling, coughing, tongue clicking, animal sounds and grunting. Grunting is often caused by orophyrynx muscles (contributes in respiratory and digestive system) contractions or diaphragm contraction.
Complex motor tics can be identified with long duration within seconds which is more than simple tics. It includes mainly two types namely coproraxia and echopraxia.
Copropraxia is occurence of indecent gestures or actions and echopraxia is the imitation of others behavior without any intention for example imitating body language. Complex motor tics also include jumping and twirling. It may also result in touching objects and other people.
Complex vocal tics mainly include coprolalia and echolalia. Coprolalia is using obscene language or socially unacceptable words respectively. It also assume that if a person while talking is swearing again and again unnecessarily and have no control over this is also coprolalia while echolalia can be understand by the phenomenon of echo sound because in this case the person repeat involuntarily most recent sound. It is a weird repetition of sound and words which sometimes might be offensive. Uttering sentence or words which are out of context is another form of echolalia.
The symptoms can be disappear with time. If not, seeking neurologist is helpful regarding reducing the symptoms and syndrome.
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Team Doctor ASKY!