Turning Down Tourette Disorder

Most people think they know what Gilles de la Tourette syndrome is. However, the inappropriate and unprompted utterance of foul language, a symptom called coprolalia, that is the most characteristic symptom of the disease is not a common feature of the condition, let alone a necessary one. Tourette syndrome is actually primarily expressed in physical tics, repetitive movements compulsive such as eye blinks, face or hand movements, throat clearing, coughing, or sniffling. Though verbal tics are also part of the condition, these are far more often noises than bad words.

People with Tourette syndrome often also have obsessive-compulsive disorder, and there are some indications that the two conditions may be related. When the verbal tics are words—often, they are noises—those words seldom relate to the person’s thoughts at the time. However, the obsessive thoughts that commonly afflict people with OCD can come out in verbal tics of Tourette disorder, made all the worse by attempts to suppress them. While people with Tourette syndrome often have a limited ability to keep the tics under control for a short time, they often have the tics come back all the worse afterwords. However, most patients gradually learn to keep their symptoms more or less under control.

Tourette syndrome and OCD are often treated together, as treatment for the compulsive behavior will also help reduce the frequency or severity of tics. Mild cases of the condition can often be treated with therapy; for more severe cases, medication may be needed to help control the symptoms. As with ADHD, stimulant medications may be a counter-intuitively effective treatment option that can provide some relief. Botox injections in the relevant muscles won’t do much to stop the impulses behind motor tics, but the injection can stop the tics themselves. Medications to block the neurotransmitter dopamine do lessen those impulses.

Another chemical in the brain that seems to be involved with Tourette syndrome is gamma amino-butyric acid, or GABA, a neurotransmitter related to anxiety. Electrical brain stimulation has been proposed to help regulate GABA, increasing levels of the chemical to turn down the movements and tics of Tourette syndrome.

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