Tourette Syndrome

What is Tourette Syndrome?

A hereditary, neurological disorder characterized by repeated involuntary movements and uncontrollable vocal sounds called tics. This disorder evidences itself most often between the ages of six and 15, but may occur as early as age two or as late as age 20. The first symptoms often are involuntary movements (tics), most commonly of the face, followed by the arms, legs or trunk. These tics are frequent, repetitive and quick.Verbal tics (vocalizations) usually occur with the movements, but later may replace one or more movement tics. Vocalizations include grunting, throat clearing, shouting and barking. Verbal tics also may be expressed as coprolalia (the involuntary use of obscene words or socially unacceptable words and phrases) or copropraxia (obscene gestures). It is estimated that in 70 percent of cases, the tics disappear in a person's early 20s.

The major problem faced by people with TS is socialization and acceptance by peers because the condition can be quite embarrassing. Often, tic symptoms do not cause serious enough impairment to require medication. However, there are many types of medications prescribed for those whose symptoms interfere with functioning. Because all of these medications have potentially serious side effects, they should be prescribed in the lowest effective dosage.

Treatment Options

Deep Brain Stimulation (DBS) has emerged as a potential option for select Tourette syndrome (TS) patients whose motor and/or vocal tics significantly impact the quality of life despite maximal use of other treatment options. The media buzz surrounding DBS for TS has been exciting; however, it has created many questions for patients and their families to consider. In this update we aim to address the most commonly asked questions and also we aim to update the current state of DBS for TS.

Why would DBS help to in Tourette Syndrome?

DBS has the potential to “neuromodulate” abnormal communication that occur deep within the brains of people with TS. So far researchers have probed into several areas in the brain of people with TS (the centromedian thalamus, the internal globus pallidus, the external globus pallidus, and the anterior limb of the internal capsule) and they have had mixed success. The best target for “neuromodulation” has yet to be determined, however it does appear that DBS has positive results in some patients.

 

Information courtesy of the American Association of Neurological Surgeonswww.tsa-usa.org/

 

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