What is Tic Disorder (Tourette Syndrome)? Symptoms, Causes, and Treatment

What is Tic Disorder (Tourette Syndrome)?

Tic disorder is a neurological condition that causes involuntary, repetitive movements and sounds. Tics are divided into vocal and motor types based on the repetitive behavior. They are further classified as simple or complex depending on the areas of the body affected. Different symptoms occur according to these tic types. Generally, symptoms such as facial grimacing, eye blinking, and grunting may be observed.

A diagnosis of tic disorder is made by a doctor observing the symptoms. There is no specific test for tic disorder. There is also no definitive cure for tic disorder. Treatment is applied to reduce symptoms. Medication, psychotherapy, and behavioral therapy can be used to reduce symptoms. If you have tics that negatively affect your daily life, you can consult a mental health professional to learn methods for coping with tics.

What is Tic Disorder?

Tic disorder, or Tourette syndrome, is an inherited neurological condition that causes involuntary tics and repetitive sounds. Tics are a general term for involuntary movements and sounds made by people. It usually appears in childhood and develops into adulthood. The tics that cause Tourette syndrome are motor and vocal. Behaviors involved in tics are called simple if they affect a few parts of the body, and complex if they affect several different parts.

What Are the Symptoms of Tic Disorder?

Symptoms of tic disorder are usually mild. However, they can sometimes become severe. Especially situations of stress, excitement, and fatigue increase their intensity. In tic disorder, symptoms such as eye tics, jaw movements, and grunting are seen. Tic disorder causes different symptoms depending on the type of tic. Symptoms seen according to the type of tic are as follows:

Simple motor tics: These involve muscle movements affecting one part of the body. These are sudden, uncontrollable movements such as constant eye blinking, facial grimacing, jaw movement, head shaking, or shoulder shrugging.

Simple vocal tics: These involve repetitive sounds affecting one part of the body. Movements such as constant throat clearing, grunting, shouting, barking, and sniffing occur.

Complex motor tics: These are muscle movements that occur in several parts of the body. These movements include jumping, hopping, stretching, and obsessively touching and grasping objects.

Complex vocal tics: This is a type of tic where repetitive sounds occur as a result of several parts of the body being affected. Symptoms seen in complex vocal tics include repetitive movements such as the person repeating their own words or those of others, and using slang words.

What Causes Tic Disorder?

There is no definitive cause for tic disorder. There are currently theories about the factors that cause the development of tic disorder. Factors that may cause tic disorder are as follows:

Genetic factors: In families, tic disorder is passed to the child through genes. Genetics is the most common cause of tic disorder.

Streptococcal infection: It is thought that an infection causes the neurological changes seen in tic disorder. Streptococcal bacterial infections can have life-threatening characteristics. Therefore, it is thought that tic disorder may develop as a result of a Streptococcal infection.

Neurochemical abnormalities: It can develop as a result of anomalies in neurotransmitters such as dopamine, serotonin, and norepinephrine, which provide communication between neurons in the brain. Differences occur in the metabolism of these neurotransmitters.

Other disorders: Tic disorder can develop in cases of anxiety, attention deficit hyperactivity disorder, learning disabilities, and sleep disorders.

How is Tic Disorder Diagnosed?

There is no biochemical test such as a blood or urine test for the diagnosis of tic disorder. Sometimes, blood, urine, and imaging methods may be used to rule out other diseases. The most definitive way to diagnose is to examine the person's symptoms. The doctor first examines the family history, medical history, and the patient's symptoms. The doctor makes the diagnosis if the symptoms have the following characteristics:

Experiencing both vocal and motor tics intermittently for more than 1 year,

The movements and sounds being repetitive and not caused by medication, substances, or medical conditions,

The tics starting before adulthood.

How is Tic Disorder Treated?

Tic disorder is a neurological disease with no cure. A treatment method based primarily on reducing symptoms is applied. These methods vary from person to person depending on the severity of the symptoms. Mild tics that do not affect daily activity do not require treatment. Medication and psychotherapy can be applied for severe and moderate tics.

Medication

No single medication cures Tourette syndrome. Therefore, a doctor may prescribe more than one medication to reduce symptoms. However, because medications have side effects such as weight gain, depression, and feeling constantly tired, they are not suitable for every patient. Therefore, medication is not the first treatment method. Medication may be resorted to in cases where tics are severe and affect daily activities.

Psychotherapy

Psychotherapy is resorted to in cases where psychological conditions such as depression, anxiety, and attention deficit hyperactivity disorder accompany tics. By enabling the person to cope with these psychological disorders, the symptoms of tic disorder are alleviated. In addition, relaxing activities such as relaxation exercises and meditation can prevent stress-induced tics from worsening.

Behavioral Therapy

If tic disorder in children results in learning difficulties or causes problems in daily activities and at school, it is necessary to apply behavioral therapy. Two different behavioral therapy methods are applied by a psychologist or psychiatrist:

Habit reversal training: With this method, the feelings that cause the tics are evaluated. Then, the aim is to find an alternative way to reduce the tics. For example, the goal is to replace a swearing tic with a more tolerable behavior because it puts the person in a difficult situation in social environments.

Exposure and response prevention: With this approach, the aim is to manage the urge to tic. The focus is on the feeling of being able to stop without performing the tic by creating the urge to tic.

Deep Brain Stimulation

In cases where severe tics do not respond to other methods, deep brain stimulation may be resorted to. The aim is to send electrical stimulation to the area of the brain that controls the ability to move. It is a method currently in the research stage.

If tic disorder negatively affects your daily activities and quality of life, you can consult a mental health professional to learn methods for coping with tics through psychotherapy. This prevents tics that occur during stress or excitement from worsening.

Frequently Asked Questions

For the diagnosis and treatment of tic disorder, a child psychiatrist or mental health professional should be consulted. The mental health professional examines the child's symptoms, family history, and medical history. As a result of these evaluations, they make the diagnosis. Along with this, they inform you about the treatment. Tics start in childhood. Sometimes they improve after a few years and do not recur. Sometimes they continue into adolescence and improvement is observed at the beginning of adulthood. However, in some children, it can start in early childhood and last a lifetime. Tics can be reduced by engaging in any activity or by developing another behavior to replace the tic behavior. Tics do not disappear completely. For this reason, psychotherapy is applied to reduce tics. The aim of psychotherapy is to change behavior and ensure coping with stress. Tic disorder usually shows its first symptoms in children aged 5 to 10. The first symptoms appear in the head and neck area. As the child reaches adolescence, tics are seen in their most severe form. Usually, symptoms disappear in early adulthood. However, some people have tic disorder in adulthood as well. Tics have different types depending on the affected area and whether they involve movement and sound. There are four different types of tics: motor, vocal, simple, and complex. While motor tics involve involuntary muscle movements, vocal tics involve repetitive sounds. Tics are also classified as simple and complex tics according to the affected body area. Simple tics affect one part of the body. Complex tics affect more than one part of the body. The most well-known cause of tics is genetics. Having tics in the family and relatives causes the development of tic disorder in the child as well. Tic disorders are divided into different categories according to the behavior that occurs. Among tic disorders, Tourette syndrome is the most severe. Other types of tic disorders:

Transient tic disorder: Motor or vocal tics lasting less than one year

Persistent tic disorder: Motor or vocal tics lasting longer than one year

Tourette syndrome: Motor and vocal tics lasting longer than one year

In children, eye blinking tics can be caused by stress, spending long periods in front of a screen, allergies, and fatigue. Usually, eye tics improve on their own. However, follow-up is required to prevent the development of Tourette syndrome. While some tics are mild and harmless, some tics have harmful characteristics to the person. For example, tics that cause a person to hit themselves and tics that include swearing are harmful to the person. In addition, it can cause the person to be perceived as aggressive. Especially tics that cause swearing can lead to unnecessary punishment for children at school and at home.

Tic disorder (Tourette syndrome) is a neurological condition that begins in childhood and can affect quality of life. With accurate diagnosis and appropriate treatment methods in the early period, it is possible to bring symptoms under control.

If you observe tic symptoms in yourself or your child, you can consult Hisar Hospital Neurology specialist doctors to get information about detailed evaluation and personalized treatment methods.

Contact us now to make an appointment and receive professional support in the process of coping with tics.