Writer｜Jessie Liao
Layout Designer｜Cecilia Qin
Introduction
If you see someone sitting in front of you twitching and spasming non-stoppablely, hold back for a few seconds before criticizing them because they may not be able to control it. This is what's known as Tourette syndrome, a neurological disorder that is characterized by sudden unwanted and uncontrolled rapid and repeated movements or vocal sounds called tics. This passage will delve further into this enigmatic condition that affects approximately 1% individuals of the human population .
Potential Cause
Tourette syndrome is a heterogeneous disorder in which the phenotypic expression may be affected by environmental factors, such as immune responses. Several studies have indicated that genetic factors play a significant role in the development of Tourette syndrome and its co-occurrence with other disorders, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and autism spectrum disorder (ASD). The syndrome has a complex inheritance pattern and, according to various genetic studies, several genes and loci have been correlated with it , including dopamine, serotonin, and norepinephrine, which are neurotransmitters that facilitate communication between nerve cells, or help nerve cells talk to one another. However, all current studies require further confirmation due to lack of consistent results. On the other hand, copy number variations, which are polymorphisms, result from changes in the number of gene copies due to chromosomal deletions or duplications, are also considered significant contributors of mutations for Tourette syndrome. In the past decade, researchers have made exciting discoveries regarding genetic mutations in individuals with Tourette syndrome through whole genome/exome sequencing.
Hence, more studies are needed to reveal the exact mechanisms of the underlying syndrome, which may help to provide more information on the prognosis and therapeutic plans. Learning to suppress symptoms, even for brief moments, can significantly improve the quality of life for patients experiencing severe symptoms. This could be a precious experience for those who struggle with managing their condition .
Symptoms
The defining characteristic of Tourette syndrome is the presence of tics, which are sudden, brief, and intermittent movements or sounds, ranging from mild to severe. Tics are similar to hiccups in that they are involuntary actions of the body, regardless of whether or not one wants to experience them , you just simply can't control them. Symptoms of Tourette syndrome typically start between ages 5 and 10, with the first symptoms often being motor tics, one of the two types apart from vocal tics, in the head and neck area. When dealing with mild symptoms, it is likely for patients to maintain a normal daily routine. However, severe symptoms can severely hamper communication, daily activities, and overall quality of life.
Firstly, motor tics, which commonly involve frequent eye blinking, head jerking, shoulder shrugging, darting eyes, nose twitching and even mouth movements.
More complex motor tics, which resulted from distinct and coordinated patterns of movements instead of simple and brief ones, include touching or smelling objects, obscene gesturing, bending or twisting and hopping. On the other hand, vocal tics, which produce sounds, are often expressed through grunting, coughing, throat clearing and barking.
Complex ones include repeating others' words and phrases or their own, or sometimes even using swear words. These tics show variations among individuals, such as differences in type, frequency, and severity, thus it should be noted that patients may exhibit varying behaviors during an onset, as each individual's response to the situation may differ.
Diagnosis
Well, not just anyone who makes noises or does something baffling or repetitive is considered to have Tourette syndrome, often the diagnosis of Tourette syndrome requires a person to have both motor and vocal tics for at least one year. This diagnosis method relies solely on the judgement of health professionals, unlike other diseases which are diagnosed through methods such as blood tests.
Treatment
While Tourette Syndrome has no cure, there are treatments available to manage the tics
associated with it. For individuals experiencing disruptive tics that cause pain, injury, interfere with daily life or create stress, medication and behavioral treatments like Comprehensive Behavioral Intervention for Tics (CBIT) are available. While CBIT is an acronym for a highly structured therapy that typically takes place in an office on a weekly basis. The process includes habit reversal and education about tics, along with relaxation techniques. It's effective in reducing tic symptoms and related impairment. A therapist works with the person to identify triggers and change surroundings if possible. The person also learns new behaviors to replace tics through habit-reversal techniques. CBIT skills can be learned with the help of an experienced therapist and support from those close to the person with tic disorders. Behavioral therapy can effectively manage Tourette syndrome symptoms. However, few clinicians are trained in this approach for tic disorders. The CDC and The Tourette Association of America are working to educate more health professionals in this area.
Educating others about Tourette syndrome can reduce teasing and stress for those with the condition. When people understand that tics are involuntary and not purposely made disruptive behavior, they can provide more support which may help lessen symptoms .
Medications can help reduce disruptive tics and related symptoms of ADHD or OCD, but they cannot eliminate tics completely. Finding the most suitable medication and dosage may take time, and the presence of side effects should be carefully considered. Medications do not yield the same results for everyone, and side effects or lack of effectiveness may be reasons to avoid their use.
Conclusion
There is still much to learn about Tourette syndrome, which we know little about. The main reason that we should discover more is that there are still people suffering from it. "These are things you would never notice if you're just having a conversation with me but, for me, they're very exhausting.", is what Billie Eilish, the singer, says about her experience. While the movie "Front of the Class" depicts the struggles of the main character to become the teacher he always wanted to be, despite his symptoms. Understanding more about this syndrome and showing respect to those who have it is the least we can do before seeking a cure .
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