What are Tics and Tourette Syndrome?

Tics are involuntary, repetitive movements or sounds that can vary in type, frequency, and severity. They can be classified as motor (affecting muscles) or vocal (affecting speech). Motor tics include movements like shoulder shrugging, facial grimacing, or head jerking. Vocal tics include repetitive utterances such as grunts, throat clearing, or words.

Tourette Syndrome (TS) is a neurodevelopmental disorder that causes people to have multiple motor and vocal tics that last for more than a year. Tics and Tourette syndrome are more common in children and can significantly impact daily activities and quality of life.

According to a 2021 article in the Australian Journal of General Practice, Tourette syndrome has a prevalence of approximately 1% in school-aged children. The Tourette Syndrome Association of Australia also reports it affects around 1 in 100 children.

The main symptom of tics and Tourette syndrome is having involuntary and repetitive movements or sounds. Motor tics can be simple (involving a limited number of muscles) or complex (involving several muscle groups).

Some examples of motor tics are:

  • grimacing
  • blinking
  • eye darting
  • shrugging
  • nose twitching
  • head banging
  • obscene gesturing
  • jumping and twisting

Vocal tics can also be simple, such as:

  • throat clearing
  • sniffing
  • grunting

Or complex, such as:

  • repeating words or phrases
  • involuntary swearing
  • calling out

The exact cause of tics and Tourette syndrome is unknown, but it may involve a combination of genetic, developmental and neurological factors. Some possible causes and risk factors are:

  • A family history of tics or Tourette syndrome increases the risk of inheriting the condition.
  • Having mutations in certain genes that affect brain development and function may play a role. Such as Down’s, Fragile X, XY, and others
  • Abnormalities or imbalances in brain chemicals called neurotransmitters, such as glutamate, serotonin, and dopamine, may affect nerve cell communication and cause tics.
  • Other causes: Head trauma, drugs (cocaine, neuroleptics), neurodegenerative disorder (HD), autism, encephalitis, infections (HIV)

Tics and Tourette syndrome are diagnosed based on the history of signs and symptoms, without any specific tests. The criteria used to diagnose Tourette syndrome include:

  • Both motor tics and vocal tics are present, although not necessarily at the same time
  • Tics occur several times a day, nearly every day or intermittently, for more than a year
  • Tics begin before age 18
  • Tics are not caused by medications, other substances or another medical condition

Your neurologist may also request some tests (such as blood tests, CT scan or MRI) to rule out other possible causes of tics.

Treatment Options for Tics and Tourette Syndrome

Some of the treatment options for tics and Tourette syndrome are:

Behavioral Therapies

Habit reversal cognitive behavioral therapy (HRT) is a technique that teaches patients to recognize the urge to tic and replace it with a competing response that inhibits the tic. Other forms of behavioral therapy include exposure and response prevention (ERP) and comprehensive behavioral intervention for tics (CBIT).

Medications

Some drugs that can reduce tics are:

  • alpha agonists (clonidine or guanfacine)
  • antipsychotics (haloperidol, pimozide, or risperidone)
  • antidepressants (fluoxetine or sertraline)
  • benzodiazepines

However, these medications may have considerable side effects and should be used with caution.

Botulinum toxin injections

Local intramuscular injections of botulinum toxin type A can temporarily and slightly weaken the muscles involved in tics, especially vocal tics. This treatment may require repeated injections every few months.

Deep brain stimulation (DBS)

It involves implanting electrodes in specific brain regions that control movement. Electrical impulses are delivered to these regions to modulate their activity. This treatment is reserved for severe, refractory cases of tics that do not respond to other therapies.

We are here for you

Are you looking for a compassionate and experienced specialist that can help you manage your condition? At Melbourne Neurocare, we offer a range of treatment options for tics and Tourette syndrome, including behavioral therapy, medications, botulinum toxin injections, and deep brain stimulation surgery. Don’t let tics or Tourette syndrome interfere with your quality of life. Contact Melbourne Neurocare today and book an appointment with one of our specialists.

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