Tourette
Syndrome
Information and Support Site
Welcome
- What to expect from our site.
Our
mission at Tourettes-Disorder.com is to give hope and encouragement
to those searching to understand Tourette’s Disorder also referred
to as Tourette Syndrome, Tourettes, and sometimes Tourette Spectrum
Disorder. Some of the goals we have to accomplish this are to:
1. Push an aggressive awareness of Tourette's Syndrome Disorder to
the public, patients, and professionals.
2.
Promote & index up-to-date resources for learning, teaching, and
researching knowledge, facts, or fiction about Tourette’s Syndrome
Disorder.
3.
Provide information about Tourette’s Syndrome Disorder as defined
in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
and the spectrum of, or comorbid
conditions sometimes experienced in connection with this neurological
disorder.
4.
Publish awareness and insight to tough questions about the mental,
physical, emotional and spiritual struggles patients with Tourette's
Syndrome Disorder may deal with.
5.
Prevent some of the pain, hurt, and embarrassment due to a misunderstanding
of Tourette’s Syndrom Disorder.
"One
of the worst aspects of this condition is the lack of public awareness
of it and the unjustified and hurtful blaming of innocent patients
for behavior not of their making." - Dr. Donohue, heraldtribune.com
Thank
you for visiting Tourette's Disorder. We hope you leave more
aware than how you came! Click here
to start your introduction into Tourette's Disorder
Tourette
Syndrome Introduction
Click
Here to read the following introduction on it's own page and with
the interactive graphics.
Tourette
Syndrome is also referred to as Tourette’s Disorder, Tourette’s,
TS and sometimes Tourette Spectrum Disorder.
Tourette
Syndrome is best defined in the archives and pages of neurological
conditions, syndromes, and disorders. Initially Tourette Syndrome
was seen as extremely rare and an individual was viewed as having
violent muscle contortions (motor tics) and vocal disruptions (vocal
tics) combined with outburst of swearing and obscenities. (Tourette
history) However Dr. David E. Comings writes in Tourette Syndrome
and Human Behaviour, "...Tourette Syndrome is one of the most
common genetic conditions affecting humanity and many more carry the
trait."
Tourette
Syndrome - Tourette's Disorder is a neurological disorder characterized
by involuntary body movements and vocal outbursts (Tics)
for at least 12 months.
Note:
There are no longer any requirements for severity or impairment.
The
reason for having the tics for at least 12 month is specified is because
transient tics – a brief period or one-off episode of tics –
are really common in children (occurring in around ten per cent) and
these people get better.
Tourette
Syndrome is named after a French physician, Georges
Gilles de la Tourette, who first described Tourette
it in 1885. Tourette Syndrome commonly appears in childhood, more
often in males than females, and may worsen thereafter or subside.
The
absolute cause of Tourette Syndrome is unknown, nonetheless many theories
and advanced information has increased considerably since 1885.
No
cure yet exists, but symptoms are often treatable with various
medications, behavioural therapy and alternative treatments. It should
be noted that there is not any peer reviewed scientific evidence,
yet, of success with "alternative therapies." Even results
of behavioural therapy are unclear long-term, and are going to be
studied on a well-designed TSA grant possibly starting in 2004.
The
"tics" symptoms involving
Tourette Syndrome are known to temporarily aggravate with increased
stress. Also the tics can wax and wane or come and go through out
the patient's life. It is also normal for the tics to change
and return. Some of the Tourette tics can be suppressed for small
periods of time, however generally return with greater aggravation.
It should also be noted that most persons with Tourette Syndrome do
not require medication for their tics.
Neurodevelopmental
disorders including Tourette Syndrome can have substantial overlap
with other disorders.
There
is a possibility of common co-morbid conditions found in patients
with Tourette Syndrome though they are not required for diagnosis.
("co-morbid"
means the presence of one or more disorders (or diseases) in addition
to a primary disease or disorder.) Examples are Obsessive-Compulsive
Disorder OCD, and Attention Deficit Hyperactivity Disorder ADHD.
All of the available information about co-morbid conditions in regard
to Tourette Syndrome isn't clear and is considered a complicated
subject between clinicians and researchers.
Patients
with Tourette's Syndrome who have other conditions as well, may be
at increased risk for a whole host of other problems, but many of
the problems may not be due to Tourette Syndrome but to other conditions
they may have.
Some
of the other conditions and/or terms you may find discussed in circles
that deal with Tourette Syndrome are: Tourette
Syndrome "Plus", Tourette
Spectrum Disorder, Anxiety Disorders,
Depression Disorders, Paediatric
Autoimmune Neuropsychiatric Disorders Associated with Streptococcal
Infections PANDAS, Sensory
Integrative Dysfunction SID, Rage Attacks - Storms, Sleep Disorders,
Dysinhibition.
There
are people with Tourette Syndrome that have no other co-morbid conditions,
disorders or problem behaviours. They could be referred to as having
"TS-Only." They would meet the minimal DSM criteria
for Tourettes Disorder; which is they have had vocal and motor tics
for at least 12 months.
One
of the less common possible symptoms of Tourettes yet the most highly
publicized would be Coprolalia
(outburst of obscenities and curse words).
Coprolalia is actually very uncommon in Tourette Syndrome and only
effects as low as 5% to 15% of Touretter’s. Coprolalia is not
required for a diagnosis.
Any
medical doctor M.D. knowledgeable about Tourette Syndrome can diagnose
the disorder. This includes paediatricians, psychiatrists, neurologist,
geneticists, etc. Non-physicians can also suggest the Tourette diagnosis
including psychologists and mental health therapists and even teachers,
but only medical doctors M.D.'s can prescribe medications and most
insurance companies require an "official" diagnosis"
by a medical doctor M.D.
How
to Define Tourettes Disorder?
The
definition of Tourette Syndrome has changed over time and is not fixed
from one person or clinician to another. A definition is
intended for clarity among clinicians and researchers. One patients
or clinicians definition may not represent a "thing" that
you have.
Tourette
Syndrome as defined close to the diagnostic criteria (DSM-IV-TR)
for Tourette's Disorder could simply be “Tourette Syndrome is
a neurobiological condition resulting in motor and vocal tics for
at least 12 months.”
Some
recognize Tourette's as a spectrum disorder, “…with some
people having a few tics and others having tics plus features of other
(comorbid) conditions such as obsessions, compulsions, inattention,
impulsivity, mood variability.”
- Leslie Packer PhD
There are those that feel “…Tourette Syndrome
rarely exists in isolation and is part of a global neurological dysfunction,
which includes but is not limited to tics, and dysinhibition. Where
does one draw the line? Is “this” a symptom of “Tourette
Syndrome” or is it part of “ADHD” or “OCD”
or, does it really matter? Tourette Syndrome is… something more
akin to “cross wiring” and the reality being that daily
function requires one deal with what is thrown at one regardless as
to what it is called."
- Colleen Wang, Tourette Spectrum Association Inc.
Here again is also a great perception and explanation of Tourette
Syndrome. "Tourette Syndrome is not a disease; it is a syndrome,
a cluster of recognizable patterns. There are no tests for it. The
diagnosis is by history and observation only, and the boundary is
fuzzy. No one has decided how many tics a day are necessary to call
it a tic disorder. (Spitting 3 times in school, for example, will
probably result in a phone call, whereas 10,000 eye-blinks won't!)
Although tics are often described as "rapid" or "sudden,"
not all are; some tics are "held" or "tonic" movements
involving freezing in a position for a few seconds. "Purposeless"
is another descriptor, but because many tics are preceded by an uncomfortable
feeling to which the tic is a response, this word also isn't very
satisfactory. The definition is simply a multiple, changing pattern
of tics (not necessarily at the same time) for at least 12 months,
including at least one noise-making tic. (There is no requirement
for severity or impairment.) You can have Tourette Syndrome and function
normally."
- Roger D. Freeman, M.D
Reflecting
more than 25 years of research; two of the leading international authorities
on Tourette’s Syndrome and tic-related, obsessive-compulsive
disorders narrate Tourettes this way. "Tourette Syndrome was
considered rare and exotic at one time (however now,) Tourette's
syndrome is a relatively common childhood-onset disorder defined by
persistent motor and vocal tics and frequently associated with obsessions,
compulsions, and attentional difficulties."
- James F. Leckman, Donald J. Cohen of the Yale Child Study Center.
As you
can read all the above opinions and descriptions vary in definition.
Regardless, they will all have similar goals for a Tourette
patient. They want a Tourette patient to have the support and information
they will need to deal with Tourette Syndrome and or any other disorder
they experience. The ultimate goal would be for patients and
families to live happy and productive lives with joy to the best of
their abilities.
Finally
a very important subject to understand is; many people diagnosed with
Tourette’s Disorder may have a variety of other conditions that
they deal with. Nonetheless, Tourette’s Disorder is by
DSM-IV-TR definition listed under Childhood
/ Adolescent,Tic Disorders and characterized by involuntary body movements
and vocal, outbursts. Though the DSM categorization is under
Childhood / Adolescent, Tic Disorders, don't misunderstand this categorization,
as it is based on age of onset and diagnosis.
Continue
to an in depth Diagnostic Criteria here or
jump to our Tourette Information pages here.
Paul
Marshall
editor@tourettes-disorder.com
Top
of page
Tourette
Syndrome "Plus"
Leslie E. Packer, PhD. 1998-2003
http://www.tourettesyndrome.net
Tourette
Syndrome Now What? tsnowwhat, 2000-2003
http://tourettenowwhat.tripod.com/about_ts.htm
Tourette
Spectrum Association Colleen Wang
http://www.tourettesyndrome.org/
Tourette
syndrome: minimizing confusion
Roger D. Freeman, M.D
http://www.tourette-confusion.blogspot.com/
HopePress
- David E. Comings M.D.
http://www.hopepress.com
Tourette's
Syndrome -- Tics, Obsessions, Compulsions: Developmental Psychopathology
and Clinical Care
- James
F. Leckman, Donald J. Cohen
mrindianajones
Paul Marshall PhD
2000-2003
http://www.mrindianajones.com
