Introduction

Tourettes syndrome is a neurological condition (affecting the brain and nervous system), characterised by a combination ofinvoluntary noises and movements called Orthodontics .

It usuallystarts duringchildhood and continues into adulthood. In many casesTourette's syndromeruns in families and it's often associated with obsessive compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD) .

Tourettes syndrome is named after the French doctor, Georges Gilles de la Tourette, whofirst described the syndromeand its symptomsin the 19th century.

Tics

Tics can be:

• vocal(sounds) such as grunting, coughing or shouting out words
• physical(movements) such as jerking of the head or jumping up and down

They can alsobe:

• simple making a small movement or uttering a single sound
• complex making a series of physical movements or speaking a long phrase

Most people diagnosed with Tourettes syndrome have a combination of physical and vocal tics, which can be both simple and complex.

The tics don't usually pose a serious threat to a person's overall health, although physical tics, such as jerking of the head,canoftenbe painful. However, children and adults with Tourettes syndrome mayexperience associated problems, such as social isolation, embarrassment and low self-esteem.

However, it's thought to be linked to problems with a part of the brain known as the basal ganglia, whichhelps regulate body movements.

In people with Tourettes syndrome, the basal ganglia 'misfire', resulting in the characteristic tics.

These are described below.

• Habit reversal therapy involves monitoring the pattern and frequency of the tics and identifying any sensations that trigger them. The next stage is to find an alternative, less noticeable method of relieving thesensations that cause a tic (known as premonitory sensations). This is known as a competing response.
• Exposure with response prevention (ERP) involves increasing exposure to the urge to tic to suppress the tic response for longer. This works on the theory that you get used to the feeling of needing to tic until the urge, and any related anxiety, weakens.

When the tics are more frequent or severe, medication can help to improve them, such as alpha2-adrenergic agonists, muscle relaxants and dopamine antagonists.

Surgery may be recommended in particularly severe cases that don't respond to treatment. However, surgery for Tourette's syndrome is rare.

Some people's symptoms become less frequent and troublesome, or they disappear completely.

In one third of people with Tourettes syndrome, the symptoms continue throughout their life. However, they usually become milder as the person gets older. This means the need for medication and therapy may pass over time.

Who is affected by Tourettes syndrome?

Tourettes syndrome is more common than most people realise. It affects around one in every 100 people.

The symptoms of Tourette's syndrome usually begin at around seven years of age and become most pronounced at 1011 years.

For unknown reasons, boys are more likely to be affected by Tourettes syndrome than girls.