Tourette Syndrome

The exact number of people with the neurotype, Tourette's, is estimated around 1% of adolescent and school-age children worldwide. Of the people diagnosed with Tourette syndrome, more than one-third also have Obsessive-Compulsive Disorder (OCD) and about 42% have at least one co-occurring chronic health condition[i].

Most interestingly, among children diagnosed with Tourette syndrome:

• • • 37% have been reported to have severe or moderate forms of this condition.

    • People from every ethnic and racial group can have Tourette syndrome but oddly Caucasian children are twice as likely to be diagnosed than People of Colour[ii].

    • 50% to 75% of cases improve dramatically in adulthood.

Medical Classification

Tourette syndrome is classified by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM). Tourette's is diagnosed "when the individual has multiple motor and vocal tics that have been present for at least 1 year and that have a waxing-waning symptom course"[iii].

Diagnosing characteristics of Tourette syndrome are:

A. Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently.

B. The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset.

C. Onset is before age 18 years.

D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington’s disease, postviral encephalitis).

The DSM, explained

To help you better understand and relate with the diagnosing characteristics described by the DSM, here is a thorough and easy-to-digest explanation:

A. Presence of Multiple Motor and One or More Vocal Tics (Which May Not Occur Simultaneously) during the Illness

People with Tourette syndrome usually have multiple motor tics that occur with at least one vocal tic. These motor tics are divided into simple tics (which involve a single muscle group) and complex tics (which involve more than one muscle group). Some of these simple motor tics are nose wrinkling, shoulder shrugging, and lip biting; complex vocal tics are smelling objects, kicking, and skipping.

Like motor tics, there are also simple vocal tics (which involve simple sounds) and complex vocal tics (which involve more meaningful speech, like words). Some of these simple vocal tics are hissing, coughing, and barking; complex vocal tics are yelling, animal sounds, and repeating words and phrases which are either inoffensive or vulgar, (as in coprolalia) which occurs in about a quarter of Tourette syndrome cases.

B. Motor and Vocal Tics Must Have Persisted for More Than a Year

These motor and vocal tics that occur in people with Tourette syndrome usually persist for more than a year. During diagnosis, after this time, it is more likely that the occurrence of tics can be attributed to a possible case of Tourette syndrome.

C. Tics Must Occur Before Age 18 Years

This is pretty straight-forward. To diagnose a tic as a symptom of Tourette syndrome, the tic must have occurred before the age of 18. Tics that occur at any other age will be diagnosed as symptoms of another tic disorder.

D. The Tics Must Not Be a Result of Drugs or Other Underlying Illnesses

The tics must be as a result of a neurological disorder [iv](or in rare cases, genetic mutations) free of influences from drugs (like heroin, cocaine, and marijuana), even medicines like stimulants, and other illnesses like bacterial and viral infections which can spark up an abnormal immune response that can trigger a sudden onset of tics. When drug and other illnesses influences are ruled out, then the tics could be a possible sign of Tourette syndrome.

Getting Diagnosed Helps!

Prior to your diagnosis, a lot could be running through your mind: Since Tourette syndrome symptoms could be mistaken for a range of other psychiatric or neurological conditions, it is hard to tell if you have this neurotype or not. Getting a diagnosis will ease your mind and give you more information on your neurotype and how to properly handle it. With a diagnosis, you also get to meet other fascinating and special people like you, with Tourette syndrome.

Hidden in the challenges faced by people with Tourette syndrome are special strengths. A few of which are energy, humour, creativity, impressive language skills. It is important you note that these strengths are unique, and each person will have varying degrees of the traits.

Article written by Jane Okoji (9 Sep, 2020; UPDATED JUN 11, 2020)

References:

[i] Centre for Disease Control and Prevention. (2020, June 12). Data & Statistics on Tourette Syndrome. Retrieved from Centre for Disease Control and Prevention: https://www.cdc.gov/ncbddd/tourette/data.html#ref

[ii] Centre for Disease Control and Prevention. (2009, June 5). Morbidity and Mortality Weekly Report. Retrieved from Prevalence of Diagnosed Tourette Syndrome in Persons Aged 6–17 Years — United States, 2007: https://www.cdc.gov/mmwr/PDF/wk/mm5821.pdf

[iii] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, United States of America: American Psychiatric Publishing.

[iv] Krans, B. (2019, December 24). Transient Tic Disorder (Provisional Tic Disorder). Retrieved from Healthline: https://www.healthline.com/health/transient-tic-disorder