Tourette's syndrome

Tourette's syndrome is the most well-known of the tic disorders.

It was discovered by Giles de la Tourette in France in 1885.

Other names

 * Tourette syndrome
 * Tourette's disorder
 * Tourette disorder
 * TS
 * TD (very rarely used)
 * Giles de la Tourette syndrome
 * Giles de la Tourette's syndrome
 * GTS (rarely used)

Symptoms
The main symptoms of Tourette's are tics, but the condition can include social, organisation and concentration problems. If these are severe enough, they are diagnosed as separate conditions.

Diagnosis
Tourette's syndrome is best diagnosed by a neurologist as it is a neurological condition. The diagnosis is made by observing the symptoms and listening to the patient. Some tests may be undertaken to rule out other conditions.

Diagnostic criteria
According to the International Statistical Classification of Diseases and Related Health Problems (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), to be diagnosed with Tourette's syndrome, the patient must fulfill the following criteria:


 * Has both multiple motor tics and one or more vocal tics at the same time although not necessarily concurrently.


 * The tics must occur many times a day, nearly every day or intermittently over more than one year, during which time there must not have been a tic-free period of more than three consecutive months.


 * The age at onset must be less than 18 years.


 * The disturbance must not be due to the direct physiological effects of a substance (e.g. stimulants) or a general medical condition (e.g. Huntington's disease or postviral encephalitis).

Screening
When a diagnosis is being made, the doctor may undertake tests to rule out other conditions. These tests include EEG, MRI, CT scan, or certain blood tests,

Treatment
Most cases of Tourette's are not severe enough to warrant pharmaceutical treatment, especially as the drugs available have many side effects which often far outweigh the benefits, however more and more people are experimenting with vitamins and minerals to help calm their tics.

Treatment for Tourette's syndrome cannot remove the condition, but it can improve it while the treatment is undergone.

Pharmacological
There is a range of pharmaceutical medication available to minimise tics, but they have many side effects which often far outweigh the benefits.

List of medications
This is not a complete list.


 * Clonazepam (Rivotril)
 * Clonidine (Catapress/Dixarit)
 * Fluphenazine (Prolixin)
 * Haloperidol (Dozic/Haldol/Serenace)
 * Mellaril
 * Navane
 * Pimozide (Orap)
 * Risperidone (Risperdal)
 * Sulpiride (Dolmatil, Sulparex, Sulpitil)

Side effects
Possible side effects include, but are not limited to:
 * akathisia
 * anxiety
 * bradykinesia
 * cognitive blunting
 * convulsions
 * dizziness
 * drooling
 * dystonia
 * depression
 * fatigue
 * headaches
 * heart problems
 * increased risk of diabetes
 * insomnia
 * irritability
 * metabolism abnormalities
 * parkinsonism
 * restlessness
 * tardive dyskinesia
 * tremors
 * weight gain

Alternative
Many people are trying out alternative forms of treatment for Tourette's. Some believe that it may be caused by a vitamin and mineral deficiency or dependency. Some have found relief by using treatments to rid the gut of candida, an intrusive yeast which is naturally present but an overgrowth can occur, leading to various symptoms, including brain fog and poor absorption of nutrients - possibly leading to vitamin and mineral deficiency.

Results have been varied, with some experiencing no effects and others experiencing full disappearence of symptoms.

Nutitional therapy
People have found relief using various vitamins and minerals for Tourette's syndrome.

Vitamins

 * B1 (thiamin)
 * B2 (riboflavin)
 * B3 (niacin)
 * B6 (pyridoxine)
 * B12
 * folic acid
 * inositol
 * choline

Some people use multivitamin supplements. This will not work for everyone as sometimes it is the wrong balance of vitamins which is the problem, not purely a deficiency. Also, too much of one vitamin can prevent other vitamins from being used.

Minerals

 * magnesium
 * zinc
 * potassium
 * calcium

Herbs and other

 * essential fatty acids
 * fish oil (some people have reported an increase in tics)
 * flaxseed oil
 * evening primrose oil
 * grape seed extract
 * Pycnogenol®
 * glycine
 * lecithin
 * taurine
 * tryptophan
 * DMG (Dimethylglycine)
 * DMAE (Dimethylaminoethanol)
 * blue green algae
 * St. John's wort (although mainly for obsessive compulsive symptoms, anxiety and depression)
 * chamomile
 * hops
 * lady's slipper
 * passion flower leaves
 * skullcap
 * valerian
 * wood betony

Alternative non-medicinal

 * biofeedback
 * cognitive behavior therapy
 * chiropractic
 * hypnotherapy
 * sound/music therapy
 * relaxation techniques
 * massage
 * prayer
 * cranial/sacral therapy
 * meditation
 * aromatherapy
 * acupuncture
 * acupressure
 * reflexology
 * guided imagery

Comorbidity
Comorbid conditions of Tourette's syndrome include:
 * obsessive compulsive disorder (OCD)
 * attention deficit/hyperactivity disorders
 * attention deficit disorder (ADD)
 * attention deficit hyperactivity disorder (ADHD)
 * hyperactivity
 * pervasive developmental disorders
 * autism (Kanner's syndrome)
 * Asperger's syndrome(AS)
 * nonverbal learning disorders
 * problems with impulse control
 * sensory integration disorder (SID)
 * executive dysfunction
 * auditory processing disorder
 * anxiety disorders
 * generalised anxiety disorder (GAD)
 * panic disorder
 * dyspraxia
 * dyslexia
 * sleep problems

Similar conditions
Some conditions may look like Tourette's syndrome. These include:
 * other tic disorders (some argue that they are variations of Tourette's syndrome)
 * myoclonus
 * ataxia
 * dyspraxia
 * epilepsy
 * restless legs sndrome (RLS)
 * dystonia
 * tremor
 * Parkinson's disease
 * cerebral palsy
 * Huntington's chorea
 * extreme stuttering

Misconceptions
Tourette's syndrome is commonly referred to as the 'swearing disease' due to the fact that the most publicised symptom is that of involuntary swearing (coprolalia). However, this only occurs in between 10-15% of people with the condition. These outbursts of swearing also lead people to believe that Tourette's syndrome is an anger management disorder. This is not the case. Tourettic swearing occurs whatever mood the person is in.