Tourette Syndrome (TS) is a neurological disorder affecting behavior of the affected person, the condition begins between the ages of 2 and 21, and lasts throughout life.
Tourette Syndrome manifests in adolescence (before age 18) and is attributed to genetic and environmental factors.
“It is a neurobehavioural disorder that occurs because of dysfunction in the areas of the brain involved in movement and behaviour – basal ganglia, cerebral cortex and the thalamus,” says Dr Anshu Rohatgi, senior consultant neurologist at Sir Ganga Ram Hospital in Delhi.
While the exact cause for Tourette Syndrome is not known, genetics plays a major role. “If someone has Tourette, there is a 50% chance that it may be passed onto to the children,” says Dr Rohatgi.
What are the symptoms?
TS is characterised by rapid, repetitive and involuntary muscle movements and vocalisations called “tics”, and often involves behavioural difficulties. The term “involuntary”, used to describe tics, is a source of confusion since it is known that most people with TS do have some control over their symptoms.
What is often not recognised is that the control which can be exerted, from seconds to hours at a time, only delays more severe outbursts of symptoms.
Tics are experienced as a build up of tension, are irresistible and eventually must be performed. Typically tics increase as a result of tension or stress and decrease with relaxation or concentration on an absorbing task.
TS symptoms have long been misconstrued as a sign of behavioural abnormality or “nervous habits”, which they are not.
The two categories of the tics of TS and some common examples are:
- Motor – eye blinking, head jerking, shoulder shrugging, facial grimacing, nose twitching
- Vocal – throat clearing, barking noises, squealing, grunting, gulping, sniffing, tongue clicking
- Motor – jumping, touching other people and things, twirling about, repetitive movements of the torso or limbs, pulling at clothing and self-injurious actions including hitting or biting oneself
- Vocal – uttering words or phrases, coprolalia (the involuntary utterance of inappropriate or obscene words), echoalia (repeating a sound, word or phrase just heard) or palilalia(repeating one’s own words)
The variety and complexity of tics or tic-like symptoms that can be seen in TS is enormous.
Do people with TS have all of these symptoms or just some of them?
People with TS rarely have all of these symptoms. Most people will exhibit some or many symptoms over a long period of time and in varying degrees: mild, moderate or severe. In milder cases a person may have just a few tics or twitches, which may be confined to the face, eye and shoulder areas. In more severe cases several areas of the body may be affected.
The symptoms wax and wane, in some cases from day to day but more commonly over 3 to 4 month periods. The waxing and waning pattern can sometimes be frightening to people with TS who may find it difficult to understand the sudden intensification or waning of symptoms.
Radlyn Naidoo, a student of University of Pretoria is one who suffers from Tourette Syndrome. He rose to popularity with his is vocal talent that helped temporarily stop his tics.
The 19-year-old student gave people a glimpse into the world of a Tourette Syndrome sufferer when a video he posted quickly went viral.
Are there behaviour problems which may occur frequently in addition to tics?
Yes, but not always. Additional problems may include:
Obsessive Compulsive Disorder (OCD), in which the person feels that something must be done over and over. Examples include touching an object with one hand after touching it with the other to “even things out” and repeatedly checking to see that the flame on the stove is turned out. Children sometimes repeat a sentence or action many times until it is “just right”. OCD can include counting rituals, obsessive preoccupations or thoughts which are unpleasant.
Attention Deficit &/or Hyperactivity Disorder (ADD/ADHD) may include difficulty in concentrating, being easily distracted, failing to finish tasks, acting on impulse, not seeming to listen, shifting constantly from one activity to another, needing a great deal of supervision, being unable to sit still, calling out and lack of self-control. Adults may have residual signs of ADD such as overly impulsive behaviour and concentration difficulties. Learning Difficulties such as dyslexia, arithmetic and perceptual difficulties, handwriting problems.
Behavioural problems may include compulsive and repetitive behaviours, attention problems, sleep difficulties, depression, poor self-esteem, poor school performance, social isolation, school and social phobia. Some commonly observed problems include oppositional/defiant behaviour, aggressive and uncooperative behaviours.
It’s time to learn about Tourette’s Syndrome, a neuropsychiatric disorder that manifests itself in motor or vocal tics. A kind of audible hichki if you like. Rani Mukerji returns to the big screen with a character who suffers from Tourette’s Syndrome and is determined to become a teacher in Hichki.
Click here to watch the trailer of Hichki