One of the most misunderstood conditions is Tourette's syndrome. Swearing and saying otherwise inappropriate words and phrases, for example, is commonly perceived as the main symptom. In fact, this aspect of Tourette's is present in only 10% of people with the syndrome. Here's a guide to this complex condition.
What is Tourette's syndrome?
Tourette's syndrome is a neurological condition that's inherited and it affects over 300,000 children and adults in the UK. Tourette's syndrome, which is characterised by involuntary 'tics', is linked to other behavioural and mental health conditions, including obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) and depression. It can be diagnosed from the age of around six, although milder cases may go undiagnosed until teenage years or early adulthood. Tics commonly manifest at around five years old, but have to have been apparent for a year before diagnosis is undertaken.
What are tics?
Tics are involuntary movements or sounds that people with Tourette's feel compelled to do in order to satisfy an urge. It often seems as though they must have some choice over when they tic and what they do, but this is untrue. Tics are beyond the control of the individual displaying them. When a person with Tourette's displays a tic, there is often an immediate but short-lived sense of relief. Because it's so short-lived, it's not long before the tic is repeated. This can be tiring, humiliating and demoralising for the person with the condition as well as for their family.
What different tics are there?
Tics include physical movements such as quite dramatic-looking limb jerking; pronounced blinking; facial contortions and hitting out. People usually have their own individual physical tics. There is a whole catalogue of different physical tics, far too many to describe here. Some examples have included obscene touching; foot dragging; spitting; eye rolling; punching (either themselves or others); finger snapping; poking people and deep knee bending.
Vocal tics include high-pitched yelping; throat clearing or coughing; sniffing; repeating certain words, sometimes at volume and throughout otherwise normal speech; swearing or using otherwise inappropriate language (known as 'coprolalia'); parroting what other people say and tongue clicking. As with physical tics, people with Tourette's have their own individual sounds. The characteristic they share is that their tics are out of their own control.
How is Tourette's syndrome diagnosed?
Tourette's syndrome is usually diagnosed by a neurologist, but diagnosis can also involve a psychiatrist and/or a clinical psychologist. Tics need to have been apparent for at least a year, without breaks of any longer than three months. This is because lots of children go through a stage of having tics, and some adults have them, without fulfilling other diagnostic criteria for Tourette's. There are ratings scales to assess the severity of tics and other diagnostic tests are sometimes carried out in order to rule out other conditions, such as autism, epilepsy and dystonia. Further tests can include EEG (electroencephalogram), which is a scan that monitors brain activity; CT or CAT scan (computerised tomography), which creates detailed 3D images of the brain using X-rays; MRI (magnetic resonance imaging), which is another type of scan that maps the inside of the brain; or blood tests.