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Tourette syndrome
Classification and external resources
Head and shoulders of a man with a shorter Edwardian beard and closely cropped hair, in a circa-1900 French coat and collar
Georges Gilles de la Tourette
(1859–1904)
ICD-10 F95.2
ICD-9 307.23
OMIM 137580
DiseasesDB 5220
MedlinePlus 000733
eMedicine med/3107 neuro/664
MeSH D005879
.Tourette syndrome (also called Tourette's syndrome, Tourette's disorder, Gilles de la Tourette syndrome, GTS or, more commonly, simply Tourette's or TS) is an inherited neuropsychiatric disorder with onset in childhood, characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic; these tics characteristically wax and wane.^ Tourette syndrome (also called Tourette's syndrome , Tourette's disorder , Gilles de la Tourette syndrome , GTS or TS ) is an inherited neurological disorder with onset in childhood, characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Detection of major gene for Gilles de la Tourette syndrome.
  • Gilles de la Tourette's Syndrome: Genetics and Dopamine [MJM 1997 3: 29-35] 28 January 2010 1:01 UTC www.medicine.mcgill.ca [Source type: Academic]

^ Bliss J. Sensory experiences of Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Tourette's is defined as part of a spectrum of tic disorders, which includes transient and chronic tics.^ Transient tic disorder .
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that represents the most complex and severe manifestation of the spectrum of tic disorders.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]
  • Fetal Alcohol Spectrum Disorder - Online Clinic 6 February 2010 13:47 UTC www.online-clinic.com [Source type: Academic]

.Tourette's was once considered a rare and bizarre syndrome, most often associated with the exclamation of obscene words or socially inappropriate and derogatory remarks (coprolalia).^ Tourette syndrome was once considered a rare and bizarre syndrome .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Most tics associated with Tourette's syndrome diminish or disappear after adolescence.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Non-obscene complex socially inappropriate behavior in Tourette''s syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.However, this symptom is present in only a small minority of people with Tourette's.^ One such association has been reported, but it affects at most a small minority of people with tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ However, a small number of cases will present mild deficits in motor coordination, reflex symmetry or mirror movements, especially in cases with concurrent ADD (6,12).
  • Gilles de la Tourette's Syndrome: Genetics and Dopamine [MJM 1997 3: 29-35] 28 January 2010 1:01 UTC www.medicine.mcgill.ca [Source type: Academic]

^ Coprolalia was originally described as a pathognomonic symptom by Gilles de la Tourette, but it occurs in only 8 to 39 percent of patients, mostly males, and is not required for a diagnosis.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[1] .Tourette's is no longer considered a rare condition, but it may not always be correctly identified because most cases are classified as mild.^ It is no longer considered rare, but is often undetected because of the wide range of severity, with most cases classified as mild.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ That is no longer the case.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Although there is no such thing as a "typical" case of Tourette’s Syndrome, the condition follows a fairly reliable course in terms of the age of onset and the history and severity of symptoms.
  • Symptoms of Tourette's Syndrome - Tourette's Disorder Treatment 15 September 2009 4:26 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

.Between 1 and 10 children per 1,000 have Tourette's;[2] as many as 10 per 1,000 people may have tic disorders,[3][4] with the more common tics of eye blinking, coughing, throat clearing, sniffing, and facial movements.^ The prevalence of Tourette's syndrome is one to 10 cases per 10,000.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Examples of vocal tics are throat clearing, sniffing or barking noises.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tics may also occur more slowly.
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

.People with Tourette's have normal life expectancy and intelligence.^ People with Tourette’s Syndrome can live a normal life span and intelligence is not affected in any way.
  • Symptoms of Tourette's Syndrome - Tourette's Disorder Treatment 15 September 2009 4:26 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

^ Life span and intelligence are normal, although learning disabilities may be present.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Accomplished musicians, athletes, public speakers, and professionals from all walks of life are found among people with Tourette's syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.The severity of the tics decreases for most children as they pass through adolescence, and extreme Tourette's in adulthood is a rarity.^ Use of levetiracetam to treat tics in children and adolescents with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Most tics associated with Tourette's syndrome diminish or disappear after adolescence.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that represents the most complex and severe manifestation of the spectrum of tic disorders.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]
  • Fetal Alcohol Spectrum Disorder - Online Clinic 6 February 2010 13:47 UTC www.online-clinic.com [Source type: Academic]

.Notable individuals with Tourette's are found in all walks of life.^ Tourette syndrome is found among all social, racial and ethnic groups.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Environmental physicians do not claim to have a cure for Tourette syndrome, but individuals undergoing such specialized treatment for allergies have sometimes found their Tourette syndrome symptoms improving significantly.
  • Letters from Patients and Families: Tourette Syndrome - Free Article 28 January 2010 1:01 UTC www.latitudes.org [Source type: FILTERED WITH BAYES]

^ Accomplished musicians, athletes, public speakers, and professionals from all walks of life are found among people with Tourette's syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[5]
.Genetic and environmental factors each play a role in the etiology of Tourette's, but the exact causes are unknown.^ Causes and origins: genetic and epigenetic factors .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The precise etiology of Tourette's syndrome is unknown.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Researchers found that the children exposed to these perinatal risks were two to three times as likely to develop Tourette syndrome with ADHD, suggesting that these factors play a role in the development of ADHD in children with Tourette as well.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]
  • People Often Experience Both Tourette And ADHD Combined 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.In most cases, medication is unnecessary.^ Most cases of Tourette's disorder are mild and will not need medical treatment.
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

^ However, most cases are diagnosed by merely observing a history of tics, and medical tests are not always called for.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Most cases of TD are mild and will not require medical treatment.
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

.There is no effective medication for every case of tics, but there are medications and therapies that can help when their use is warranted.^ There are no medications specifically designed to target tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ There are medications, but there’s no cure.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Other medications that can be used to treat tics include pergolide (brand name Permax®), botulinum toxin , and with less empirical support for efficacy, tetrabenazine and baclofen .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Explanation and reassurance alone are often sufficient treatment;[6] education is an important part of any treatment plan.^ Referred (clinical) populations of patients with Tourette's have a high rate of comorbid ADHD, so the treatment of ADHD co-occurring with tics is often part of the clinical treatment of Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Thus, educating the child and the family about tics is often sufficient.
  • Treatments for Tourette Syndrome - WrongDiagnosis.com 28 January 2010 1:01 UTC www.wrongdiagnosis.com [Source type: Academic]

[7]
The eponym was bestowed by Jean-Martin Charcot (1825–93) on behalf of his resident, Georges Albert Édouard Brutus Gilles de la Tourette (1859–1904), a French physician and neurologist, who published an account of nine patients with Tourette's in 1885.

Contents

Classification

.Tics are sudden, repetitive, stereotyped, nonrhythmic movements (motor tics) and utterances (phonic tics) that involve discrete muscle groups.^ Tics are defined as sudden, rapid, purposeless, repetitive, nonrhythmic, stereotyped movements or vocalizations.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Tics are usually sudden movements or sounds.
  • Fetal Alcohol Spectrum Disorder - Online Clinic 6 February 2010 13:47 UTC www.online-clinic.com [Source type: Academic]

^ (A tic is a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[8] .Motor tics are movement-based tics, while phonic tics are involuntary sounds produced by moving air through the nose, mouth, or throat.^ Tics are usually sudden movements or sounds.
  • Fetal Alcohol Spectrum Disorder - Online Clinic 6 February 2010 13:47 UTC www.online-clinic.com [Source type: Academic]

^ Simple phonic tics are simple vocalizations or sounds.
  • Tourette Syndrome: eMedicine Pediatrics: Developmental and Behavioral 28 January 2010 1:01 UTC emedicine.medscape.com [Source type: Academic]

^ Motor tics are movement-based tics affecting discrete muscle groups.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Tourette's is one of several tic disorders, which are classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM) according to type (motor or phonic tics) and duration (transient or chronic).^ Tourette's syndrome is one of the most common causes of motor and phonic tics.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th edition.
  • Gilles de la Tourette's Syndrome: Genetics and Dopamine [MJM 1997 3: 29-35] 28 January 2010 1:01 UTC www.medicine.mcgill.ca [Source type: Academic]

^ Stress and tic severity in Tourettes Prot .
  • Tourette Syndrome - BrainTalk Communities 28 January 2010 1:01 UTC brain.hastypastry.net [Source type: FILTERED WITH BAYES]

.Transient tic disorder consists of multiple motor tics, phonic tics or both, with a duration between four weeks and twelve months.^ Transient tic disorder .
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ Two of the most socially distressing motor tics, both of which can be seen in TS, include echopraxia (imitations of movements made by another) or copropraxia (obscene gestures or movements).
  • Gilles de la Tourette's Syndrome: Genetics and Dopamine [MJM 1997 3: 29-35] 28 January 2010 1:01 UTC www.medicine.mcgill.ca [Source type: Academic]

^ Since vocal tics result from a "motor event (ie, a contracting diaphragm moving air through the upper airways)", TS could be defined as a disorder of motor tics, eliminating the distinction between TS and the other tic disorders.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Chronic tic disorder is either single or multiple, motor or phonic tics (but not both), which are present for more than a year.^ Diagnostic criteria for transient tic disorder (D-1 and D-2) This disorder is characterized by single or multiple motor and/or vocal tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Boys are more likely than girls to have chronic tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Diagnostic criteria for chronic multiple motor tic or phonic tic disorder (B-1 and B-2) Either multiple motor or vocal tics, but not both, have been present at some time during the illness.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[8] .Tourette's is diagnosed when multiple motor tics, and at least one phonic tic, are present for more than a year.^ For it to be diagnosed as Tourettes he will have had to had the tics for over a year.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ He said to keep an eye on it and if it continues for more than a year, than he would diagnose Tourette’s.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Motor tics are more common than vocal tics.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[9] .Tic disorders are defined similarly by the World Health Organization (International Statistical Classification of Diseases and Related Health Problems, ICD-10 codes).^ Definitions and classification of tic disorders.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ The World Health Organization -- fact sheet .

^ World Health Organization – fact sheets .

[10]
.Although Tourette's is the more severe expression of the spectrum of tic disorders,[11] most cases are mild.^ Tourette's is part of a spectrum of tic disorders, including transient and chronic tics.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ In most cases, tics peak in severity between nine and 11 years of age.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Stress and tic severity in Tourettes Prot .
  • Tourette Syndrome - BrainTalk Communities 28 January 2010 1:01 UTC brain.hastypastry.net [Source type: FILTERED WITH BAYES]

[12] .The severity of symptoms varies widely among people with Tourette's, and mild cases may be undetected.^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Antihypertensives and/or muscle relaxants are usually prescribed for patients with mild to moderate symptoms, while neuroleptics are more commonly given to those with moderate to severe symptoms.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ In some cases, it may be necessary to treat both the ADHD and the Tourette's syndrome with a stimulant in combination with either clonidine or guanfacine, or with a neuroleptic agent.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[8]

Characteristics

.Tics are movements or sounds "that occur intermittently and unpredictably out of a background of normal motor activity",[13] having the appearance of "normal behaviors gone wrong".[14] The tics associated with Tourette's constantly change in number, frequency, severity and anatomical location.^ The anatomic location, number, frequency, complexity, or severity of tics changes over time.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ People with Tourette have motor and vocal tics -- rapid, repetitive, meaningless movements and sounds.
  • People Often Experience Both Tourette And ADHD Combined 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ People with Tourette have motor and vocal tics — rapid, repetitive, meaningless movements and sounds.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.Waxing and waning—the ongoing increase and decrease in severity and frequency of tics—occurs differently in each individual.^ The neurologist watched a videotape I had and asked some questions and said it was a tic, and would likely go away in a year or two, possibly after waxing and waning...
  • Alltop - Top Tourette's Syndrome News 28 January 2010 1:01 UTC tourette.alltop.com [Source type: General]

^ Severe and frequent tics may require treatment, including medicine and counseling.
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

^ Over the next few years the tics may change in location and become more severe and/or frequent at times.
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

.Tics also occur in "bouts of bouts", which vary for each person.^ Tics are described as occurring in "bouts of bouts", which vary for each person.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In the course of an office visit, tics tend to occur in bouts rather than being distributed evenly.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Seeing another person with tics with excessive blinking may induce a bout of blinking in someone who has not had that tic for years.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[8]
.Coprolalia (the spontaneous utterance of socially objectionable or taboo words or phrases) is the most publicized symptom of Tourette's, but it is not required for a diagnosis of Tourette's and only about 10% of Tourette's patients exhibit coprolalia.^ I am only talking about tourettes in my own words and knowledge.
  • Alltop - Top Tourette's Syndrome News 28 January 2010 1:01 UTC tourette.alltop.com [Source type: General]

^ Coprolalia (the spontaneous utterance of socially-objectionable or taboo words or phrases) is the most publicized symptom of Tourette's syndrome, but it is not required for a diagnosis of Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Previous versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) included a requirement for distress or impairment in social, occupational, or other important areas of functioning, but this requirement has been removed from the most recent version of the DSM, in recognition that not everyone with the diagnosis has distress or impairment to functioning.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[15] .Echolalia (repeating the words of others) and palilalia (repeating one's own words) occur in a minority of cases,[8] while the most common initial motor and vocal tics are, respectively, eye blinking and throat clearing.^ Echolalia (repeating others' words or statements) .
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Examples of vocal tics are throat clearing, sniffing or barking noises.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Palilalia (repeating one's own statements, words or parts of words) .
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[16]
Video clips of tics
HBO documentary video clip
CBS News video clip
From the TSA, an adult with tics
.In contrast to the abnormal movements of other movement disorders (for example, choreas, dystonias, myoclonus, and dyskinesias), the tics of Tourette's are stereotypic, temporarily suppressible, nonrhythmic, and often preceded by an unwanted premonitory urge.^ An investigation of tic suppression and the rebound effect in Tourette's disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Are there other tic disorders ?
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

^ In contrast to the stereotyped movements of some other movement disorders (e.g.; choreas , dystonias , myoclonus , and dyskinesias ), the tics of Tourette's are temporarily suppressible and preceded by a premonitory urge.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[17] .Immediately preceding tic onset, most individuals with Tourette's are aware of an urge,[18][19] similar to the need to sneeze or scratch an itch.^ Immediately preceding tic onset, most individuals with TS are aware of a premonitory urge, [5] which is similar to the need to sneeze or scratch an itch.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that represents the most complex and severe manifestation of the spectrum of tic disorders.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]
  • Fetal Alcohol Spectrum Disorder - Online Clinic 6 February 2010 13:47 UTC www.online-clinic.com [Source type: Academic]

^ In 1885, Gilles de la Tourette, the French neurologist and student of Charcot presented 9 children with childhood onset tics.
  • Tourette Syndrome: eMedicine Pediatrics: Developmental and Behavioral 28 January 2010 1:01 UTC emedicine.medscape.com [Source type: Academic]

.Individuals describe the need to tic as a buildup of tension, pressure, or energy[19][20] which they consciously choose to release, as if they "had to do it"[21] to relieve the sensation[19] or until it feels "just right".[21][22] Examples of the premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders.^ Examples of vocal tics are throat clearing, sniffing or barking noises.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Common examples are "something in the throat," or a hard-to-describe local discomfort in the shoulders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Some examples of this premonitory urge are the feeling of having something in one's throat, or a localized discomfort in the shoulders, leading to the need to clear one's throat or shrug the shoulders.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch.^ The actual tic may be felt as relieving this tension or sensation, similar to scratching an itch.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]
  • Medical Education Online - Tourette Syndrome 28 January 2010 1:01 UTC www.medicaleducationonline.org [Source type: Academic]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ About 80 percent of patients note a premonitory sensation such as paresthesia or dysesthesia (e.g., burning or itching of the eyes before eye tics, throat “tickling” or discomfort before throat clearing, or muscular tension before shoulder shrugging) 2 before a motor or phonic tic occurs; the sensation is temporarily relieved after the movement.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ Adult TS patients describe the approach of a tic as an urge that grows more compelling, like a tickling or itch that demands to be scratched-and the only relief is the tic.
  • Tourette Syndrome: No Laughing Matter | ADD ADHD Information Library 6 February 2010 13:47 UTC newideas.net [Source type: FILTERED WITH BAYES]

.Another example is blinking to relieve an uncomfortable sensation in the eye.^ Blinking after an uncomfortable sensation in the eye is one example.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Some examples are eye blinking and grimacing.
  • Tourette Syndrome 28 January 2010 1:01 UTC www.education.com [Source type: FILTERED WITH BAYES]
  • Tourette Syndrome 2001-08-01 00:00:00.0 28 January 2010 1:01 UTC www.devoschildrens.org [Source type: FILTERED WITH BAYES]
  • Tourette Syndrome | Seattle Children's Hospital 28 January 2010 1:01 UTC www.seattlechildrens.org [Source type: General]
  • Tourette Syndrome - The Children's Hospital-Denver Area, Colorado, Rocky Mountain Region 28 January 2010 1:01 UTC www.thechildrenshospital.org [Source type: FILTERED WITH BAYES]

^ Another example is blinking to relieve an uncomfortable sensation in the eye.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]
  • Medical Education Online - Tourette Syndrome 28 January 2010 1:01 UTC www.medicaleducationonline.org [Source type: Academic]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.These urges and sensations, preceding the expression of the movement or vocalization as a tic, are referred to as "premonitory sensory phenomena" or premonitory urges.^ These urges and sensations, preceding the expression of the movement or vocalization as a tic, are referred to in Tourette's subjects as "premonitory sensory phenomena".
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ That has given him confidence, but he still gets very upset at times, especially when it hurts his body after repeated movements or vocal tics.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ They may be alternately referred to as verbal tics or vocal tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Because of the urges that precede them, tics are described as semi-voluntary or "unvoluntary",[13] rather than specifically involuntary; they may be experienced as a voluntary, suppressible response to the unwanted premonitory urge.^ They may have tics for several years before becoming aware of premonitory urges.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Due to the sensory nature of tics, they can be described as semi-voluntary or "unvoluntary", because they may be experienced as a voluntary response to an unwanted, premonitory urge.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ However, when pressed for details, adults describe most tics as a volitional response to an irresistible impulse, rather than an involuntary movement.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[15] .Published descriptions of the tics of Tourette's identify sensory phenomena as the core symptom of the syndrome, even though they are not included in the diagnostic criteria.^ Some published descriptions of the tics of Tourette's identify sensory phenomena as the core symptom of TS, even though they are not included in the diagnostic criteria.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Table 2 lists current diagnostic criteria for Tourette's syndrome.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ Tics and Tourette's syndrome are not uncommon.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[20][23][24]
.While individuals with tics are sometimes able to suppress their tics for limited periods of time, doing so often results in an explosion of tics afterward.^ Tics are often temporarily suppressible, sometimes for minutes, occasionally for hours.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ People with TS are sometimes able to suppress their tics to some extent for limited periods of time, but doing so often results in an explosion of tics afterward.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ His vocal tics are coughing, which are pretty disabling and result in long periods out of school.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[6] .People with Tourette's may seek a secluded spot to release their symptoms, or there may be a marked increase in tics after a period of suppression at school or at work.^ Some patients can suppress their tics during the school day or work day.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ People with TS may seek a secluded spot to release their symptoms after suppressing them in school or at work.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ It is believed that Tourette syndrome affects about 1 in 100 people; however, many people do not seek medical attention for the disorder because the symptoms are so mild.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]
  • People Often Experience Both Tourette And ADHD Combined 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

[14] .Some people with Tourette's may not be aware of the premonitory urge.^ Some people with TS may not be aware of the premonitory urge.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In some cases, it may be necessary to treat both the ADHD and the Tourette's syndrome with a stimulant in combination with either clonidine or guanfacine, or with a neuroleptic agent.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

^ The α 2 -adrenergic receptor agonists ( antihypertensive agents) show some efficacy in reducing tics, as well as other comorbid features of some people with Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Children may be less aware of the premonitory urge associated with tics than are adults, but their awareness tends to increase with maturity.^ As children grow older, they may become aware of the tics.
  • Tourette's Syndrome 15 September 2009 4:26 UTC www.csmc.edu [Source type: FILTERED WITH BAYES]

^ They may have tics for several years before becoming aware of premonitory urges.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Some people with Tourette syndrome may not be aware of the premonitory urge.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]

[13] .They may have tics for several years before becoming aware of premonitory urges.^ The tics motor up, but they're not severe (like before).
  • Tourette's Syndrome - User ratings & reviews - Revolution Health 28 January 2010 1:01 UTC www.revolutionhealth.com [Source type: General]

^ Some people with Tourette syndrome may not be aware of the premonitory urge.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]

^ As children grow older, they may become aware of the tics.
  • Tourette's Syndrome 15 September 2009 4:26 UTC www.csmc.edu [Source type: FILTERED WITH BAYES]

.Children may suppress tics while in the doctor's office, so they may need to be observed while they are not aware they are being watched.^ It is not uncommon for parents of affected children to be unaware that they, too, may have had tics as children.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ He sometimes may not feel a need to have a tic.
  • Tourette Syndrome in Children | Causes, Symptoms, Treatment | PDRHealth 28 January 2010 1:01 UTC www.pdrhealth.com [Source type: General]

^ Children may suppress tics while in the doctor's office, so they may need to be observed while they are not aware they are being watched.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[25] .The ability to suppress tics varies among individuals, and may be more developed in adults than children.^ Tics may affect more than one person in a family.
  • Tics and Tourette's Syndrome in Children -- familydoctor.org 15 September 2009 4:26 UTC familydoctor.org [Source type: General]
  • Tics and Tourette's Syndrome in Children -- familydoctor.org 28 January 2010 1:01 UTC familydoctor.org [Source type: General]

^ Tics may also occur more slowly.
  • Tourette's Disorder - Topic Overview - Yahoo! Health 28 January 2010 1:01 UTC health.yahoo.com [Source type: General]
  • Tourette's Disorder - Quest Diagnostics Patient Health Library 28 January 2010 1:01 UTC www.questdiagnostics.com [Source type: FILTERED WITH BAYES]
  • CIGNA - Tourette's Disorder 6 February 2010 13:47 UTC www.cigna.com [Source type: General]

^ More than half of children with Tourette syndrome develop an eye tic first.
  • Tourette Syndrome: Symtoms and Myths 28 January 2010 1:01 UTC pages.slu.edu [Source type: FILTERED WITH BAYES]

.Although there is no such thing as a "typical" case of Tourette syndrome,[6] the condition follows a fairly reliable course in terms of the age of onset and the history of the severity of symptoms.^ The gene or genes for Tourette's syndrome have not been identified, and there is no potential "cure".
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Although there is no such thing as a "typical" case, and each individual is different, Tourette's syndrome follows a fairly typical and reliable course in terms of age of onset and the natural time course of severity of symptoms.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Tourette syndrome has a great spectrum of severity.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]
  • People Often Experience Both Tourette And ADHD Combined 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.Tics may appear up to the age of eighteen, but the most typical age of onset is from five to seven.^ Tics may appear up to the age of 18, but the most typical age of onset is six or seven.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ This can be contrasted with the stereotyped movements of other disorders (e.g.; stims and stereotypies ) which tend to have an earlier age of onset, are more symmetrical, and involve extremities (e.g.; flapping hands) [21] The most common tics to appear early in the course of the condition are frequently confused with other conditions: examples are allergies , asthma , and vision problems.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In one study, 10 73 percent of patients (median age of 18 years) reported that their tics had disappeared or considerably decreased at follow-up.
  • Recognition and Management of Tourette's Syndrome and Tic Disorders - April 15, 1999 - American Academy of Family Physicians 15 September 2009 4:26 UTC www.aafp.org [Source type: Academic]

[8] .A 1998 study published by Leckman et al. of the Yale Child Study Center[26] showed that the ages of highest tic severity are eight to twelve (average ten), with tics steadily declining for most patients as they pass through adolescence.^ As the children pass through adolescence and early adulthood the severity of the tics tends to decrease.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ The statistical age of highest tic severity is typically between 8 and 12, with most individuals experiencing steadily declining tic severity as they pass through adolescence .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The ages of statistical highest tic severity are 8 to 12 (average 10), with tics steadily declining for most patients as they pass through adolescence.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[22] .The most common, first-presenting tics are eye blinking, facial movements, sniffing and throat clearing.^ Examples of vocal tics are throat clearing, sniffing or barking noises.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The most common initial tics are eye-blinking and facial movements.
  • Howstuffworks "How Tourette Syndrome Works" 28 January 2010 1:01 UTC health.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ A table presents some common examples of tics, such as eye blinking, hopping, throat clearing or repeating words.
  • Tourette Syndrome: What is Tourette Syndrome? 28 January 2010 1:01 UTC www.findingdulcinea.com [Source type: FILTERED WITH BAYES]

.Initial tics present most frequently in midline body regions where there are many muscles, usually the head, neck and facial region.^ Tics most frequently present initially in midline body regions where there are many muscles: the head, neck and facial region.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Common motor tics include forceful blinking, opening the eyes wide, head shaking and grimacing, while the most common vocal tics are sniffing, throat clearing and grunting.
  • People Often Experience Both Tourette And ADHD Combined 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ On the negative side, he has started getting headaches from all the head-bobbing– a result of tense neck muscles I believe.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[6] .This can be contrasted with the stereotyped movements of other disorders (such as stims and stereotypies of the autism spectrum disorders), which typically have an earlier age of onset, are more symmetrical, rhythmical and bilateral, and involve the extremities (e.g., flapping the hands).^ This can be contrasted with the stereotyped movements of other disorders (e.g.; stims and stereotypies ) which tend to have an earlier age of onset, are more symmetrical, and involve extremities (e.g.; flapping hands) [21] The most common tics to appear early in the course of the condition are frequently confused with other conditions: examples are allergies , asthma , and vision problems.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Tics are distinguished from other movement disorders by several typical characteristics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tics may be classified as a stereotypic movement disorder; ie, the movements are often complex and are repetitive rather than random.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[27] .Tics that appear early in the course of the condition are frequently confused with other conditions, such as allergies, asthma, and vision problems: pediatricians, allergists and ophthalmologists are typically the first to see a child with tics.^ This can be contrasted with the stereotyped movements of other disorders (e.g.; stims and stereotypies ) which tend to have an earlier age of onset, are more symmetrical, and involve extremities (e.g.; flapping hands) [21] The most common tics to appear early in the course of the condition are frequently confused with other conditions: examples are allergies , asthma , and vision problems.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ But why do we have such controversy over the PAS? With regard to whether PAS exists, we generally do not see such controversy regarding most other clinical entities in psychiatry.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Determining why tics chronically persist in a few individuals but briefly appear and then wane in others is important.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[8]
.Among patients whose symptoms are severe enough to warrant referral to clinics, obsessive–compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) are often associated with Tourette's.^ Guanfacine treatment of comorbid attention-deficit hyperactivity disorder and Tourette's syndrome: preliminary clinical experience.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ This childhood-onset movement disorder is commonly associated with obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and other psychiatric comorbidities.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

^ Obsessive Compulsive Disorder (OCD) is usually inherited.

[22] .Not all persons with Tourette's have ADHD or OCD or other comorbid conditions (co-occurring diagnoses other than Tourette's), although in clinical populations, a high percentage of patients presenting for care do have ADHD.[22][28] One author reports that a ten-year overview of patient records revealed about 40% of patients with Tourette's have "TS-only" or "pure TS", referring to Tourette syndrome in the absence of ADHD, OCD and other disorders.^ For it to be diagnosed as Tourettes he will have had to had the tics for over a year.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ How to treat OCD in patients with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ That same year Bernotas was diagnosed with Tourette syndrome.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[29][30] .Another author reports that 57% of 656 patients presenting with tic disorders had uncomplicated tics, while 43% had tics plus comorbid conditions.^ Gadow KD, Nolan EE, Sverd J. Methylphenidate in hyperactive boys with comorbid tic disorder: II. Short-term behavioral effects in school settings.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ A word about the study methodology: This study did not actually examine patients for tic disorders or OCD, rather analyzed historic computerized data.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

^ Regional cerebral blood flow in obsessive-compulsive patients with and without a chronic tic disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[14] ."Full-blown Tourette's" is a term used to describe patients who have significant comorbid conditions in addition to tics.^ Deep brain stimulation has been used in treating a few patients with severe Tourette's, but is regarded as an experimental and dangerous procedure that is unlikely to become widespread.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Author and neurologist Oliver Sacks [14] describes the case of a drummer with TS, who uses his tics to give him a certain 'flair' or 'special sound' to his drumming.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Gadow KD, Nolan EE, Sverd J. Methylphenidate in hyperactive boys with comorbid tic disorder: II. Short-term behavioral effects in school settings.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[14]

Causes

.The exact cause of Tourette's is unknown, but it is well established that both genetic and environmental factors are involved.^ Causes and origins: genetic and epigenetic factors .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Dystonias , choreas , other genetic conditions, and secondary causes of tics should be ruled out in the differential diagnosis for Tourette's syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Although much is known about how MS causes damage, the exact cause of Multiple Sclerosis remains unknown.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

[31] .Genetic studies have shown that the overwhelming majority of cases of Tourette's are inherited, although the exact mode of inheritance is not yet known,[32] and no gene has been identified.^ The gene or genes for Tourette's syndrome have not been identified, and there is no potential "cure".
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ While it is known that Tourette's is genetic, the exact mechanism affecting the inherited vulnerability has not been established.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Genetic studies have proven that the overwhelming majority of cases of Tourette's syndrome are inherited, although the exact mode of inheritance is not yet known.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[6] .In some cases, Tourette's is sporadic, that is, it is not inherited from parents.^ Tourette’s — known for its physical tics and, in some cases, shouted obscenities — has long been considered a rare condition.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Some cases of tourettism (tics due to reasons other than inherited Tourette's syndrome) can be caused by mutation .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In some cases, tics may not be inherited; these cases are identified as "sporadic" TS (also known as tourettism) because a genetic link is missing.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[33] .In other cases, tics are associated with disorders other than Tourette's, a phenomenon known as tourettism.^ CLOSE WINDOW ] Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

[34]
The basal ganglia are at the brain's center; related nearby structures are the globus pallides, thalamus, substania nigra, and cerebellum.
Brain structures implicated in Tourette's syndrome
.A person with Tourette's has about a 50% chance of passing the gene(s) to one of his or her children, but Tourette's is a condition of variable expression and incomplete penetrance.^ A person with TS has about a 50% chance of passing the gene(s) to one of his/her children.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ A person with TS has about a 50 percent chance of passing the gene to one of his/her children with each separate pregnancy.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ By the early 1990s, available data supported a single major autosomal dominant gene with pleiotropic expression (ie, chronic motor tics, TS, or OCD) and incomplete penetrance (about 70% in women, 99% in men).
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[35] .Thus, not everyone who inherits the genetic vulnerability will show symptoms; even close family members may show different severities of symptoms, or no symptoms at all.^ As a result, some individuals may actually become symptom free or no longer need medication for tic suppression.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ There is no one medication that is helpful to all people with Tourette Syndrome, nor does any medication completely eliminate symptoms.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ Typically, children who suffer with PAS will exhibit most (if not all) of these symptoms.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.The gene(s) may express as Tourette's, as a milder tic disorder (transient or chronic tics), or as obsessive–compulsive symptoms without tics.^ Regional cerebral blood flow in obsessive-compulsive patients with and without a chronic tic disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette's syndrome: what are the influences of gender and comorbid obsessive-compulsive disorder?
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Only a minority of the children who inherit the gene(s) have symptoms severe enough to require medical attention.^ Only a minority of the children who inherit the gene(s) will have symptoms severe enough to ever require medical attention.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Only 10 percent of children who inherit the gene will have symptoms severe enough to require medical attention.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[36] .Gender appears to have a role in the expression of the genetic vulnerability: males are more likely than females to express tics.^ Boys are more likely than girls to have chronic tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Males are affected 3 to 4 times more often than females.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Gender appears to have a role in the expression of the genetic vulnerability, with males more likely to express than tics than females.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[25]
.Non-genetic, environmental, infectious, or psychosocial factors—while not causing Tourette's—can influence its severity.^ Causes and origins: genetic and epigenetic factors .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Lists several genetic diseases, and the causes for them.

^ Studies suggest that non-genetic, environmental , infectious , or psychosocial factors — while not causing Tourette's — can impact upon the expression of the severity of the disorder.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[6] .Autoimmune processes may affect tic onset and exacerbation in some cases.^ Autoimmune processes may affect tic onset and exacerbation in some cases: the unproven and contentious hypothesis that pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, P.A.N.D.A.S. , plays a role in the onset of tic disorders and OCD is a current focus of research.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ It is not uncommon for parents of affected children to be unaware that they, too, may have had tics as children.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Anti-virus/malware programs try to protect you but they may not always be up-to-date or in some cases are not able to detect/fix the problem.
  • Geek News Technical News and Informational Stories - Part 1 20 September 2009 1:30 UTC www.geeknewscentral.com [Source type: General]

.In 1998, a team at the US National Institute of Mental Health proposed a hypothesis that both obsessive–compulsive disorder (OCD) and tic disorders may arise in a subset of children as a result of a poststreptococcal autoimmune process.^ Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ US National Institute of Mental Health – fact sheet .

^ Obsessive Compulsive Disorder (OCD) is usually inherited.

[37] .Children who meet five diagnostic criteria are classified, according to the hypothesis, as having Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS).^ Kurlan R, Kaplan EL. The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) etiology for tics and obsessive-compulsive symptoms: hypothesis or entity?
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ From Murphy ML, Pichichero ME. Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS).
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

^ Autoimmune processes may affect tic onset and exacerbation in some cases: the unproven and contentious hypothesis that pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, P.A.N.D.A.S. , plays a role in the onset of tic disorders and OCD is a current focus of research.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[38] .This contentious hypothesis is the focus of clinical and laboratory research, but remains unproven.^ Autoimmune processes may affect tic onset and exacerbation in some cases: the unproven and contentious hypothesis that pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, P.A.N.D.A.S. , plays a role in the onset of tic disorders and OCD is a current focus of research.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ We review current scientific information and conclude that PANDAS remains a yet-unproven hypothesis.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

[39][40]
The exact mechanism affecting the inherited vulnerability to Tourette's has not been established, and the precise etiology is unknown. .Tics are believed to result from dysfunction in cortical and subcortical regions, the thalamus, basal ganglia and frontal cortex.^ Schematic of the hypothetical reorganization of the basal ganglia output in tic disorders, with excitatory projections (open arrows) and inhibitory projections (solid arrows).
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ These pathways are relatively separated in cortex, yet they physically course closer together in the basal ganglia, thalamus, and midbrain.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Several cases of tics beginning after a focal lesion to the prefrontal cortex, basal ganglia, and thalamus have been reported.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[31] .Neuroanatomic models implicate failures in circuits connecting the brain's cortex and subcortex,[6] and imaging techniques implicate the basal ganglia and frontal cortex.^ Neuroanatomic models implicate failures in circuits connecting the brain's cortex and subcortex.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Mink JW. Neurobiology of basal ganglia circuits in Tourette syndrome: faulty inhibition of unwanted motor patterns?.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ These pathways are relatively separated in cortex, yet they physically course closer together in the basal ganglia, thalamus, and midbrain.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[41]
.Some forms of OCD may be genetically linked to Tourette's.^ Some forms of OCD may be genetically linked to Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Genetic mutation is linked to Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[22][42] .A subset of OCD is thought to be etiologically related to Tourette's and may be a different expression of the same factors that are important for the expression of tics.^ Repetitive behaviors in Tourette''s syndrome and OCD with and without tics: what are the differences?.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Genetic studies show an increased rate of tics and obsessive-compulsive behaviors or OCD in relatives of patients with Tourette's, and "reinforce the idea that at least some forms of OCD are etiologically related to TS, and may, therefore, be a variant expression of the same etiologic factors that are important for the expression of tics."
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Secondary causes of tics (not related to inherited Tourette's syndrome) are commonly referred to as tourettism.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[43] .The genetic relationship of ADHD to Tourette syndrome, however, has not been fully established.^ Their findings show that while Tourette and ADHD have a major genetic component, there are potentially preventable perinatal factors that increase the risk of a co-occurring diagnosis of ADHD in children with Tourette.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Pauls DL. Issues in genetic linkage studies of Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ It is believed that Tourette syndrome affects about 1 in 100 people; however, many people do not seek medical attention for the disorder because the symptoms are so mild.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[30]

Diagnosis

.According to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), Tourette’s Disorder may be diagnosed when a person exhibits both multiple motor and one or more vocal tics (although these do not need to be concurrent) over the period of a year, with no more than three consecutive tic-free months.^ The DSM-IV-TR criteria for tic disorders from the American Psychiatric Association, 2000 1 are as follows: Diagnostic criteria for Tourette syndrome ( DSM-IV-TR 307.23) Both multiple motor and 1 or more vocal tics have been present at some time during the illness, though not necessarily concurrently.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Diagnostic criteria for transient tic disorder (D-1 and D-2) This disorder is characterized by single or multiple motor and/or vocal tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision .
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.The previous DSM-IV included a requirement for "marked distress or significant impairment in social, occupational or other important areas of functioning", but this requirement was removed in the most recent update of the manual, in recognition that clinicians see patients who meet all the other criteria for Tourette's, but do not have distress or impairment.^ Who seems to need the meeting most?
  • WRA Boarding School Information for Troubled Teen Consultants 20 September 2009 1:30 UTC www.teenhelponline.com [Source type: FILTERED WITH BAYES]

^ DSM-IV recognizes this and doesn’t necessarily require the school to be the object of fear, but rather separation from the home, especially from someone with whom the child is pathologically attached.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ In addition, if the court does not wish to recognize the PAS diagnosis there are other DSM-IV diagnoses that are very much applicable in this case.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[44] .The onset must have occurred before the age of 18, and cannot be attributed to the "direct physiological effects of a substance or a general medical condition".[9] Hence, other medical conditions that include tics or tic-like movements—such as autism or other causes of tourettism—must be ruled out before conferring a Tourette's diagnosis.^ Dystonias , choreas , other genetic conditions, and secondary causes of tics should be ruled out in the differential diagnosis for Tourette's syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The diagnosis is made based on a history of symptoms, and after ruling out other conditions which can include tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The onset is before age 18 years.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.There are no specific medical or screening tests that can be used in diagnosing Tourette's;[22] it is frequently misdiagnosed or underdiagnosed, partly because of the wide expression of severity, ranging from mild (the majority of cases) or moderate, to severe (the rare, but more widely-recognized and publicized cases).^ There are no medications specifically designed to target tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The disorder is frequently misdiagnosed or underdiagnosed, partly because of the wide expression of severity, ranging from mild (the majority of cases) or moderate, to severe (the rare, but more widely-recognized and publicized cases).
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ There is no current test that can diagnose Tourette's.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

[26] .Coughing, eye blinking and tics that mimic asthma are commonly misdiagnosed.^ Common motor tics include forceful blinking, opening the eyes wide, head shaking and grimacing, while the most common vocal tics are sniffing, throat clearing and grunting.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Last year, that mini-episode disappear but he started the blinking eye tic.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ He is turing 5 soon, and he has just started with a head bobbing tic (he has had an eye blinking one and a breathing one in the last 2 years).
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[15]
.The diagnosis is made based on observation of the individual's symptoms and family history,[15] and after ruling out secondary causes of tic disorders.[36] In patients with a typical onset and a family history of tics or obsessive–compulsive disorder, a basic physical and neurological examination may be sufficient.^ A family study of early-onset obsessive-compulsive disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Early-onset obsessive-compulsive disorder: a subgroup with a specific clinical and familial pattern?.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Laplane D. [Obsessive-compulsive disorders caused by basal ganglia diseases].
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[11]
.There is no requirement that other comorbid conditions (such as ADHD or OCD) be present,[15] but if a physician believes that there may be another condition present that could explain tics, tests may be ordered as necessary to rule out that condition.^ If a physician believes that there may be another condition present which could explain tics, some tests may be ordered as necessary to rule out those other conditions.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Other possible causes have been ruled out, such as medications, other substances, or another medical condition.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ Comorbid ADHD, OCD, and other mood disorders should be treated when necessary.
  • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

.An example of this is when diagnostic confusion between tics and seizure activity exists, which would call for an EEG, or if there are symptoms that indicate an MRI to rule out brain abnormalities.^ Has anyone done an EEG to rule out seizures?
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ An example of this would be when diagnostic confusion between tics and seizure activity exists, which would call for an EEG , or if there are indications that an MRI is warranted to rule out brain abnormalities.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In each study, however, there was no correlation between levels of antistreptococcal titers and clinical symptoms.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

[45] .TSH levels can be measured to rule out hypothyroidism, which can be a cause of tics.^ And so, to suppress the tics, I’ve tried to figure out what has caused them.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

Brain imaging studies are not usually warranted.[45] .In teenagers and adults presenting with a sudden onset of tics and other behavioral symptoms, a urine drug screen for cocaine and stimulants might be necessary.^ He did not have an infection, but he did have an abrupt onset of symptoms which brought his tics to our attention -- although in retrospect we recognized that tics had been there all along -- and he did have increased emotional lability and other psychiatric symptoms.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

^ When medication is necessary, pharmaceutical intervention should be targeted at the most impairing symptoms, taking into account co-occurring conditions such as ADHD or OCD , which when present, may warrant treatment even when tics are mild.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The object of this study was to investigate the potential association of infections, especially group A hemolytic streptococcal infection, with the abrupt onset/exacerbation of tics or obsessive-compulsive behaviors.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

.If a family history of liver disease is present, serum copper and ceruloplasmin levels can rule out Wilson's disease.^ If a physician believes that there may be another condition present which could explain tics, some tests may be ordered as necessary to rule out those other conditions.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Most of these conditions are rarer than tic disorders, and a thorough history and examination may be enough to rule them out, without medical or screening tests.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The diagnosis is made based on a history of symptoms, and after ruling out other conditions which can include tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[11] .However, most cases are diagnosed by merely observing a history of tics.^ However, most cases are diagnosed by merely observing a history of tics, and medical tests are not always called for.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ It can be argued that MOST tics aren't observed by pediatricians in routine office visits, and few pediatricians screen for OCD, so it is not surprising, given the way this study was designed, that Tourette's or OCD diagnoses would come to the attention of the physician AFTER a strep infection.
  • PANDAS - Tourette's Syndrome Research - TS Resources - Tourette Syndrome Message Boards - Message Board - Yuku 28 January 2010 1:01 UTC tourettesyndromenowwhat.yuku.com [Source type: Academic]

^ A well-known case history describes a woman with coprolalia, among other tics, who became deaf in childhood.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[6][36]
.Secondary causes of tics (not related to inherited Tourette syndrome) are commonly referred to as tourettism.^ The cause of Tourette Syndrome has not been found.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[34] .Dystonias, choreas, other genetic conditions, and secondary causes of tics should be ruled out in the differential diagnosis for Tourette syndrome.^ Secondary causes of tics (not related to inherited Tourette's syndrome) are commonly referred to as tourettism.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The cause of Tourette Syndrome has not been found.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ CLOSE WINDOW ] Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[11] .Other conditions that may manifest tics or stereotyped movements include developmental disorders, autism spectrum disorders,[46] and stereotypic movement disorder;[47][48] Sydenham's chorea; idiopathic dystonia; and genetic conditions such as Huntington's disease, neuroacanthocytosis, Hallervorden-Spatz syndrome, Duchenne muscular dystrophy, Wilson's disease, and tuberous sclerosis.^ Tourette's syndrome occurs along of spectrum of other tic disorders , which include transient tics and chronic tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ CLOSE WINDOW ] Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Other conditions which may manifest tics or stereotyped movements include developmental disorders ( autism spectrum disorders) and Stereotypic movement disorder ; [23] other genetic conditions such as Huntington's disease , Neuroacanthocytosis , Hallervorden-Spatz disease, Idiopathic dystonia , Duchenne's disease , Tuberous sclerosis , Chromosomal disorders, Down syndrome , Klinefelter's syndrome , XYY karyotype , and Fragile X syndrome ; Wilson's disease or Syndenham's chorea ; and secondary or acquired causes of tics, such as drug-induced tics, head trauma, encephalitis , stroke , and carbon monoxide poisoning .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Other possibilities include chromosomal disorders such as Down syndrome, Klinefelter's syndrome, XYY syndrome and fragile X syndrome.^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ An example would be Down’s Syndrome, which includes a host of seemingly disparate symptoms that do not appear to have a common link.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Exon and intron variants in the human tryptophan 2,3-dioxygenase gene: potential association with Tourette syndrome, substance abuse and other disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Acquired causes of tics include drug-induced tics, head trauma, encephalitis, stroke, and carbon monoxide poisoning.^ Common motor tics include forceful blinking, opening the eyes wide, head shaking and grimacing, while the most common vocal tics are sniffing, throat clearing and grunting.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Botox_Injection_Cosmetic_Treatment.html Brain Injury Symptoms - Brain Injury Treatment Brain injury also called acquired brain injury or simply head injury, occurs when a sudden trauma causes damage to the brain.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ He treats people of all ages with tourettes and tics.There are no surgeries and no drugs.Drugs can cause more harmful side effect than do good.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[11][34] .The symptoms of Lesch-Nyhan syndrome may also be confused with Tourette syndrome.^ What are the signs and symptoms of Tourette syndrome?
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ The symptoms of Lesch-Nyhan syndrome may also be confused with Tourette syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Coprolalia (the spontaneous utterance of socially-objectionable or taboo words or phrases) is the most publicized symptom of Tourette's syndrome, but it is not required for a diagnosis of Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[27] .Most of these conditions are rarer than tic disorders, and a thorough history and examination may be enough to rule them out, without medical or screening tests.^ Volunteers will be screened with a medical history and physical and neurological examinations.
  • Magnetic Resonance Spectroscopy to Evaluate Tourette's Syndrome - Full Text View - ClinicalTrials.gov 28 January 2010 1:01 UTC clinicaltrials.gov [Source type: Academic]

^ In most cases, these tics will disappear.
  • Tourette Syndrome - body, last, causes, Meet Pete, What Is Tourette Syndrome?, What Causes Tourette Syndrome? 28 January 2010 1:01 UTC www.humanillnesses.com [Source type: FILTERED WITH BAYES]

^ Most of these conditions are rarer than tic disorders, and a thorough history and examination may be enough to rule them out, without medical or screening tests.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[6]

Screening

.Although not all people with Tourette's have comorbid conditions, most Tourette's patients presenting for clinical care at specialty referral centers may exhibit symptoms of other conditions along with their motor and phonic tics.^ Tourette syndrome patients may exhibit symptoms of other conditions along with their motor and phonic tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Coprolalia (the spontaneous utterance of socially-objectionable or taboo words or phrases) is the most publicized symptom of Tourette's syndrome, but it is not required for a diagnosis of Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[30] .Associated conditions include attention-deficit hyperactivity disorder (ADD or ADHD), obsessive–compulsive disorder (OCD), learning disabilities and sleep disorders.^ Associated conditions can include attention-deficit hyperactivity disorder (also called ADHD), obsessive-compulsive disorder (OCD), impulsiveness and learning disabilities.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Other neurobehavioral manifestations include attention-deficit-hyperactivity disorder, obsessive-compulsive disorder, poor impulse control, and other behavioral problems.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Obsessive Compulsive Disorder (OCD) is usually inherited.

[3] .Disruptive behaviors, impaired functioning, or cognitive impairment in patients with comorbid Tourette's and ADHD may be accounted for by the comorbid ADHD, highlighting the importance of identifying and treating comorbid conditions.^ Disruptive behavior in children with Tourette's syndrome: association with ADHD comorbidity, tic severity, and functional impairment.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Disruptive behaviors, overall functioning, and cognitive function in patients with co-occurring Tourette's syndrome and ADHD may be accounted for by the comorbid ADHD, highlighting the importance of identifying and treating co-occurring conditions when they are present.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[22][28][49] .Disruption from tics is commonly overshadowed by comorbid conditions that present greater interference to the child.^ If a child has disabling tics, or tics which interfere with social or academic functioning, supportive psychotherapy or school accommodations can be helpful.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Disruptive behavior in children with Tourette's syndrome: association with ADHD comorbidity, tic severity, and functional impairment.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ "It is critical to note that the comorbid conditions may determine functional status more strongly than the tic disorder."
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[6] .Tic disorders in the absence of ADHD do not appear to be associated with disruptive behavior or functional impairment,[4] while impairment in school, family, or peer relations is greater in patients who have more comorbid conditions and often determines whether therapy is needed.^ Disruptive behavior in children with Tourette's syndrome: association with ADHD comorbidity, tic severity, and functional impairment.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ "It is critical to note that the comorbid conditions may determine functional status more strongly than the tic disorder."
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[14]
.Because comorbid conditions such as OCD and ADHD can be more impairing than tics, these conditions are included in an evaluation of patients presenting with tics.^ Because co-occurring conditions like OCD or attention-deficit hyperactivity disorder can be more impairing than tics, these conditions should be included in an evaluation of patients presenting with tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ We don't know if "we lose both signals and are just adding noise to the experimental outcome" [46] when co-occurring conditions, such as OCD or ADHD, are included or excluded from study samples, or samples include/exclude children or adults, or patients with severe symptoms.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

."It is critical to note that the comorbid conditions may determine functional status more strongly than the tic disorder," according to Samuel Zinner, MD.[6] The initial assessment of a patient referred for a tic disorder should include a thorough evaluation, including a family history of tics, ADHD, obsessive–compulsive symptoms, and other chronic medical, psychiatric and neurological conditions.^ Regional cerebral blood flow in obsessive-compulsive patients with and without a chronic tic disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette's syndrome: what are the influences of gender and comorbid obsessive-compulsive disorder?
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Patient has no history of TS or chronic motor or vocal tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Children and adolescents with TS who have learning difficulties are candidates for psychoeducational testing, particularly if the child also has ADHD.[45] Undiagnosed comorbid conditions may result in functional impairment, and it is necessary to identify and treat these conditions to improve functioning.^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tics may result from a defect in this braking function.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Who says you cannot have fun with people with learning difficulties.
  • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

.Complications may include depression, sleep problems, social discomfort and self-injury.^ Occasionally, self-injury is intentional and due to a comorbid problem (eg, suicide during an episode of major depression).
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ They may reduce appetite, interfere with sleep, cause a rebound hyperactivity when they wear off , depression and delirium ( rarely).

^ Treatment We treat ADHD and ADD because we want to limit the behavioural, educational, self-esteem and social skills problems that can occur for these children.

[11]

Management

Little white pills on a counter, next to a pill bottle and labels
Clonidine (or the clonidine patch) is one of the medications typically tried first when medication is needed for Tourette's.
.The treatment of Tourette's focuses on identifying and helping the individual manage the most troubling or impairing symptoms.^ I also have read two handbook for parents sort of books on Tourette’s that have been helpful, but this one focuses on the allergy connection!
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[6] .Most cases of Tourette's are mild, and do not require pharmacological treatment;[12] instead, psychobehavioral therapy, education, and reassurance may be sufficient.^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Coprolalia (the spontaneous utterance of socially-objectionable or taboo words or phrases) is the most publicized symptom of Tourette's syndrome, but it is not required for a diagnosis of Tourette's.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The separation anxiety disorder diagnosis is most often applicable to the mild and moderate cases of PAS. In the severe cases, the anxiety element is less operative than the anger element.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[50] .Treatments, where warranted, can be divided into those that target tics and comorbid conditions, which, when present, are often a larger source of impairment than the tics themselves.^ Tics were not affected by treatment in the blinded condition.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

^ When medication is necessary, pharmaceutical intervention should be targeted at the most impairing symptoms, taking into account co-occurring conditions such as ADHD or OCD , which when present, may warrant treatment even when tics are mild.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[45] .Not all people with tics have comorbid conditions,[30] but when those conditions are present, they often take treatment priority.^ Tics were not affected by treatment in the blinded condition.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

^ Cult victims and those subjected to prisoner indoctrinations often appear to be in a trance-like state in which they profess their indoctrinations in litany-like fashion.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.There is no cure for Tourette's and no medication that works universally for all individuals without significant adverse effects.^ "No adverse effects occurred."
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ The gene or genes for Tourette's syndrome have not been identified, and there is no potential "cure".
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ There are medications, but there’s no cure.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.Knowledge, education and understanding are uppermost in management plans for tic disorders.^ O'Connor KP, Brault M, Robillard S, Loiselle J, Borgeat F, Stip E. Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[6] .The management of the symptoms of Tourette's may include pharmacological, behavioral and psychological therapies.^ A patient with Tourette's has the following treatment options - medication, non-pharmacological treatments, or surgery (rare, only when other treatments have failed) - some of which may be taken in combination: Medication - this may include antihypertensives, muscle relaxants or neuroleptics.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ Non-pharmacological treatments Behavioral therapy - commonly used to help people with Tourette's.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.While pharmacological intervention is reserved for more severe symptoms, other treatments (such as supportive psychotherapy or cognitive behavioral therapy) may help to avoid or ameliorate depression and social isolation, and to improve family support.^ Other people with TS have more severe symptoms.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Disabled_Deaf_Devices_Assistive_Technology.html Physical Rehabilitation Therapy Your health care provider may recommend physical rehabilitation therapy after an injury or surgery to help you fully recover.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ Findings such as those just described may suggest useful avenues for research into the treatment of tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Educating a patient, family, and surrounding community (such as friends, school, and church) is a key treatment strategy, and may be all that is required in mild cases.^ Findings such as those just described may suggest useful avenues for research into the treatment of tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ However, in the mild cases one might not see all eight symptoms.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Sedation can be problematic when treatment is first initiated, but may wear off as the patient adjusts to the medication.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[6][51]
4-[4-(4-chlorophenyl)-4-hydroxy-1-piperidyl]-1-(4-fluorophenyl)-butan-1-one
Model of a haloperidol molecule. Haloperidol is an antipsychotic medication sometimes used to treat severe cases of Tourette's.
.Medication is available to help when symptoms interfere with functioning.^ The majority of people with TS require no medication, but medication is available to help when symptoms interfere with functioning.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Because tic symptoms do not often cause impairment, the majority of people with Tourette Syndrome require no medication for tic suppression.However, effective medications are available for those whose symptoms interfere with functioning.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ There is no one medication that is helpful to all people with Tourette Syndrome, nor does any medication completely eliminate symptoms.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

[36] .The classes of medication with the most proven efficacy in treating tics—typical and atypical neuroleptics including risperidone (trade name[52] Risperdal), ziprasidone (Geodon), haloperidol (Haldol), pimozide (Orap) and fluphenazine (Prolixin)—can have long-term and short-term adverse effects.^ Newer neuroleptics, the atypical neuroleptics, are an alternative to the traditional medications used for treating tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The classes of medications with the most proven efficacy in treating tics — typical and atypical neuroleptics — can have long- and short-term adverse effects .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Neuroleptic medications ( antipsychotics ), such as haloperidol (brand name Haldol® ) or pimozide (brand name Orap ®), have historically been and continue to be the medications with the most proven efficacy in controlling tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[45] .The antihypertensive agents clonidine (trade name Catapres) and guanfacine (Tenex) are also used to treat tics; studies show variable efficacy, but a lower side effect profile than the neuroleptics.^ The primary pharmaceuticals that have been found to minimize tics are normally used to treat other serious illnesses (i.e., high blood pressure).
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

^ Use of levetiracetam to treat tics in children and adolescents with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[1] .Stimulants and other medications may be useful in treating ADHD when it co-occurs with tic disorders. Drugs from several other classes of medications can be used when stimulant trials fail, including guanfacine (trade name Tenex), atomoxetine (Strattera) and tricyclics.^ Others are comfortable using them and even advocate for a stimulant trial when ADHD co-occurs with tics, because the symptoms of ADHD can be more impairing than tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Medications which are used as primary treatment in other conditions are used with some success in treating tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Stimulants and other medications may be useful in treating ADHD when it co-occurs with tic disorders.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Clomipramine (Anafranil), a tricyclic antidepressant, and SSRIs—a class of antidepressants including fluoxetine (Prozac), sertraline (Zoloft), and fluvoxamine (Luvox)—may be prescribed when a Tourette's patient also has symptoms of obsessive–compulsive disorder.^ Tourette''s disorder with and without obsessive-compulsive disorder in adults: are they different?.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Sensory phenomena in obsessive-compulsive disorder and Tourette''s disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Sensory phenomena in obsessive-compulsive disorder and Tourette's disorder.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.Several other medications have been tried, including nicotine patches, but evidence to support their use is unconvincing.^ Other medications can be used when stimulants are not an option.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Other medications that can be used to treat tics include pergolide (brand name Permax®), botulinum toxin , and with less empirical support for efficacy, tetrabenazine and baclofen .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ There is good empirical support for the use of risperidone , and less support for the others.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[45]
.Because children with tics often present to physicians when their tics are most severe, and because of the waxing and waning nature of tics, it is recommended that medication not be started immediately or changed often.^ Because children with tics often present to physicians when their tics are at their highest severity, and because of the waxing and waning nature of tics, it is recommended that medication not be started immediately or changed often.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The tics of Tourette's characteristically wax and wane.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

[6] .Frequently, the tics subside with explanation, reassurance, understanding of the condition and a supportive environment.^ Frequently, the tics subside with understanding of the condition and a supportive environment.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Tics may be at their highest severity at the time that they are brought to diagnostic awareness, and often improve with understanding of the condition.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Exercise, patience, and understanding - plus keeping their environment as relaxed as possible, is key to supressing the tics.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[6] .When medication is used, the goal is not to eliminate symptoms: it should be used at the lowest possible dose that manages symptoms without adverse effects, given that these may be more disturbing than the symptoms for which they were prescribed.^ Hence, these drugs can often cause side effects or present risks serious enough to cause some TS patients to opt for living with the tics rather than take medication.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

^ Clomipramine ( Anafranil ®), a tricyclic antidepressant , and SSRIs , a class of antidepressants including Prozac , Zoloft , and Luvox , may be prescribed when a TS patient also has symptoms of Obsessive-compulsive disorder.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Dosage: Adult dose of1 mg daily given at bedtime, may be increased if necessary at 3 4wk intervalsup to 3 mg/day.
  • Medication, Medicine and Drugs for Tourette Syndrome 6 February 2010 13:47 UTC www.tourette-syndrome.com [Source type: Academic]

[6]
.Cognitive behavioral therapy (CBT) is a useful treatment when OCD is present,[53] and there is increasing evidence supporting the use of habit reversal in the treatment of tics.^ Psychoanalysis There has been a lot of good therapy for OCD using psychoanalysis.

^ Supported work and occupational therapy are useful.

^ Findings such as those just described may suggest useful avenues for research into the treatment of tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[54] .Relaxation techniques, such as exercise, yoga or meditation, may be useful in relieving the stress that may aggravate tics, but the majority of behavioral interventions (such as relaxation training and biofeedback, with the exception of habit reversal) have not been systematically evaluated and are not empirically supported therapies for Tourette's.^ Relaxation techniques and biofeedback also may be beneficial.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Cognitive Behavioral Therapy (CBT) is a useful treatment when OCD is present, and there is increasing evidence supporting the use of habit reversal in the treatment of tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Relaxation techniques , such as exercise, yoga or meditation, may also be useful in relieving stress that may aggravate tics.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[55]

Prognosis

Three men and two women stand near the Mona Lisa. All are dressed formally, one woman in a spectacular pink gown.
.
André Malraux (1901–1976) was a French author, adventurer and statesman who had Tourette syndrome.
^ Andre Malraux , the French author, adventurer and statesman, also had Tourette syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Tourette syndrome and dopaminergic genes: a family-based association study in the French Canadian founder population.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[56][57][58][59] President Kennedy, Marie-Madeleine Lioux, French Minister of Culture André Malraux, Jackie Kennedy and Vice President Johnson were photographed at the unveiling of the Mona Lisa at the National Gallery of Art, Washington, DC, in 1963.[60]
.Tourette syndrome is a spectrum disorder—its severity ranges over a spectrum from mild to severe.^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette syndrome has a great spectrum of severity.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

.The majority of cases are mild and require no treatment.^ It is no longer considered rare, but is often undetected because of the wide range of severity, with most cases classified as mild.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The disorder is frequently misdiagnosed or underdiagnosed, partly because of the wide expression of severity, ranging from mild (the majority of cases) or moderate, to severe (the rare, but more widely-recognized and publicized cases).
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ The majority of people with TS require no medication, but medication is available to help when symptoms interfere with functioning.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[12] .In these cases, the impact of symptoms on the individual may be mild, to the extent that casual observers might not know of their condition.^ Those with mild cases may be minimally impacted by symptoms, to the extent that casual observers might not know of their condition.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ However, in the mild cases one might not see all eight symptoms.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Although TS symptoms may be lifelong and chronic for some, it is not a degenerative condition and is not life-threatening.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.The overall prognosis is positive, but a minority of children with Tourette syndrome have severe symptoms that persist into adulthood.^ What are the signs and symptoms of Tourette syndrome?
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ Research into Tourette syndrome is vital.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

[31] .A study of 46 subjects at 19 years of age found that the symptoms of 80% had minimum to mild impact on their overall functioning, and that the other 20% experienced at least a moderate impact on their overall functioning.^ When mild cases progress to moderate or severe, it is highly likely that most (if not all) of the symptoms will be present.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The author and his colleagues have studied volunteers with chronic tic syndromes and control subjects by using a pharmacologic activation functional MRI (pharmacologic fMRI, or phMRI) design.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ One study of a birth cohort with TS showed that the most common age for tic onset was 9-14 years.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[8] The rare minority of severe cases can inhibit or prevent individuals from holding a job or having a fulfilling social life. .In a follow-up study of thirty-one adults with Tourette's, all patients completed high school, 52% finished at least two years of college, and 71% were full-time employed or were pursuing higher education.^ I will follow up more at a different time.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Blessings in all your follow up with the darling Doctor Carroll.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ I am a 71 yr old Lady raised in a convent boarding school and was in church 5 times a day, every day.
  • Scripture Catholic - PATRONS’ WORDS OF ENCOURAGEMENT 20 September 2009 1:30 UTC scripturecatholic.com [Source type: General]

[61]
.Regardless of symptom severity, individuals with Tourette's have a normal life span.^ Persons diagnosed with TS have a normal life span.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ The majority of people with Tourette's have normal intelligence and life expectancies.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.Although the symptoms may be lifelong and chronic for some, the condition is not degenerative or life-threatening.^ Most symptoms start in puberty or early adolescence although some forms of schizophrenia do not have symptoms until mid-life, Causes Most schizophrenia has no known causes although there is a lot of research to find the cause.

^ Mood Disorder Major Depression Chronic Dysthymia Symptoms of depression Funnily enough not many people are actually sad but some are and their mood swings a lot.

^ Although streptococcal infection may cause TS symptoms in a small subgroup of patients, the precise relationship between such infections, antineuronal antibodies, and TS remains unknown.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Intelligence is normal in those with Tourette's, although there may be learning disabilities.^ Tourette Syndrome and learning disabilities.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Although Tourette's itself does not generally affect a person's intelligence, it can cause learning difficulties.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ The majority of people with Tourette's have normal intelligence and life expectancies.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

[15] .Severity of tics early in life does not predict tic severity in later life,[15] and prognosis is generally favorable,[15] although there is no reliable means of predicting the outcome for a particular individual.^ Most symptoms start in puberty or early adolescence although some forms of schizophrenia do not have symptoms until mid-life, Causes Most schizophrenia has no known causes although there is a lot of research to find the cause.

^ Although tics are clearly not voluntary in the usual sense (no one decides to have tics), the term involuntary is not strictly accurate.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Generally, simple motor tics (eg, blinking) are first noticed when the individual is approximately 5-10 years old, with vocal tics starting at 8-15 years.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.The gene or genes associated with Tourette's have not been identified, and there is no potential "cure".[15] A higher rate of migraines then the general population and sleep disturbances are reported.^ The gene or genes for Tourette's syndrome have not been identified, and there is no potential "cure".
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ There are medications, but there’s no cure.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Dopamine receptor D2 gene polymorphisms are associated in Taiwanese children with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[15]
.Several studies have demonstrated that the condition in most children improves with maturity.^ Multiple studies have demonstrated that the condition in most children improves with maturity.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Repeat studies in the same children replicated these findings and demonstrated their temporal stability.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ In recent years, several important findings have emerged from studies of (nontic) ADHD. The reliability of ADHD diagnosis by experts compares well with that of most other medical illnesses.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Tics may be at their highest severity at the time that they are diagnosed, and often improve with understanding of the condition by individuals and their families and friends.^ Tics may be at their highest severity at the time that they are brought to diagnostic awareness, and often improve with understanding of the condition.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ People with TS are sometimes able to suppress their tics to some extent for limited periods of time, but doing so often results in an explosion of tics afterward.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.The statistical age of highest tic severity is typically between eight and twelve, with most individuals experiencing steadily declining tic severity as they pass through adolescence.^ As the children pass through adolescence and early adulthood the severity of the tics tends to decrease.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ The tics may emerge at any age, but do so most commonly between the ages of 6 and 18.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ The statistical age of highest tic severity is typically between 8 and 12, with most individuals experiencing steadily declining tic severity as they pass through adolescence .
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

.One study showed no correlation with tic severity and the onset of puberty, in contrast with the popular belief that tics increase at puberty.^ One study showed no correlation with tic severity and the onset of puberty, in contrast to the popular belief that tics increase at puberty.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Although tics are clearly not voluntary in the usual sense (no one decides to have tics), the term involuntary is not strictly accurate.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ One reviewer tried many times to replicate different shows, even tried to have everything washed and ready to go and could NOT do it after several tries.
  • Appetites: An Open Letter to the Food Network 20 September 2009 1:30 UTC www.appetites.us [Source type: FILTERED WITH BAYES]

.In many cases, a complete remission of tic symptoms occurs after adolescence.^ In many cases, complete remission of tic symptoms occurs after adolescence.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ In a few cases, complete remission occurs after adolescence.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Understand that a child has very little control over tics caused by TS. Nearly one-third of patients with TS experience remission of tic symptoms in adulthood.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[26][62] .However, a study using videotape to record tics in adults found that, although tics diminished in comparison with childhood, and all measures of tic severity improved by adulthood, 90% of adults still had tics.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Several groups have studied D2-like dopamine receptor binding in TS by using PET or single-photon emission CT (SPECT).
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ The author and his colleagues have studied volunteers with chronic tic syndromes and control subjects by using a pharmacologic activation functional MRI (pharmacologic fMRI, or phMRI) design.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Half of the adults who considered themselves tic-free still displayed evidence of tics.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ I’m curious as to the 6 week crosser - if we’re still tic free, I know it’s the food and not the cycle of the tic.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Surgery Surgery is usually only considered for adult patients with severe symptoms who have not responded well to other treatments.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

[61]
.It is not uncommon for the parents of affected children to be unaware that they, too, may have had tics as children.^ A person with Tourette syndrome may experience more frequent and possibly more intense tics when they have an infection, especially a strep ( streptococcus ) infections.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

^ Their primary interest, they profess, is the expansion of knowledge about children’s alienation from parents.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ It is not uncommon for schoolchildren to suddenly release tics when they get home from school.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.Because Tourette's tends to subside with maturity, and because milder cases of Tourette's are now more likely to be recognized, the first realization that a parent had tics as a child may not come until their offspring is diagnosed.^ My son was diagnosed at 3 (he is 7 now)with Tourettes.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Another is reason is because parents don’t punish their kids no more, because they’re afraid of going to jail or having the child called DFACS on them.
  • Atlanta health, diet and fitness news | ajc.com 20 September 2009 1:30 UTC www.ajc.com [Source type: General]

^ A person with Tourette syndrome may experience more frequent and possibly more intense tics when they have an infection, especially a strep ( streptococcus ) infections.
  • What Is Tourette Syndrome? What Causes Tourette Syndrome? 6 February 2010 13:47 UTC www.medicalnewstoday.com [Source type: Academic]

.It is not uncommon for several members of a family to be diagnosed together, as parents bringing children to a physician for an evaluation of tics become aware that they, too, had tics as a child.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ They need not always be concerned, since having several members vie for a meeting can be a healthy process.
  • WRA Boarding School Information for Troubled Teen Consultants 20 September 2009 1:30 UTC www.teenhelponline.com [Source type: FILTERED WITH BAYES]

Top half of a male athlete who appears to be running
.
Tim Howard, goalkeeper for Everton F.C., says, "Tourette's Syndrome is not a problem.
^ There could be a link between having red hair and Tourette syndrome, says a new study from the University of New South Wales.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

... .It doesn't affect me one way or another on or off the field."^ One of the surest ways the TV gets switched off or the channel changed is when people misuse the Lord’s name.
  • Atlanta health, diet and fitness news | ajc.com 20 September 2009 1:30 UTC www.ajc.com [Source type: General]

^ As soon as you block it one way, spammers will find another way around it.''
  • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

[63]
.Children with Tourette's may suffer socially if their tics are viewed as "bizarre". If a child has disabling tics, or tics that interfere with social or academic functioning, supportive psychotherapy or school accommodations can be helpful.^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tics may result from a defect in this braking function.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[36] .Because comorbid conditions (such as ADHD or OCD) can cause greater impact on overall functioning than tics, a thorough evaluation for comorbidity is called for when symptoms and impairment warrant.^ For instance, Charcot and Gilles de la Tourette distinguished tics and chorea primarily on grounds of course and presumed cause rather than phenomenology.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Conversely, relatives of children with OCD have high rates of TS whether or not the proband has TS. 124 , 125 These facts support the view that OC symptoms, like tics, are part of the natural TS phenotype rather than a comorbid second illness.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ They may, however, reveal them in the course of the evaluation, because they are such deep-seated traits, and are so deeply embedded in their personality structure, that they cannot be hidden.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[11]
.A supportive environment and family generally gives those with Tourette's the skills to manage the disorder.^ Families need support and help to manage.

^ Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Habit reversal versus supportive psychotherapy in Tourette's disorder: A randomized controlled trial and predictors of treatment response.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[64][65] .People with Tourette's may learn to camouflage socially inappropriate tics or to channel the energy of their tics into a functional endeavor.^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Because tic symptoms do not often cause impairment, the majority of people with Tourette Syndrome require no medication for tic suppression.However, effective medications are available for those whose symptoms interfere with functioning.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ Findings such as those just described may suggest useful avenues for research into the treatment of tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.Accomplished musicians, athletes, public speakers, and professionals from all walks of life are found among people with Tourette's.^ The boy should know that people in all walks of life have had to deal with this condition — professional athletes, doctors, lawyers, scientists, carpenters, truck drivers — and they all have led successful lives.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ We help people make meaning of all the things they have heard, give a professional perspective and direct them to other sources for a balanced view.

^ Most people who have Tourette Syndrome lead productive lives and participate in all professions.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.Outcomes in adulthood are associated more with the perceived significance of having severe tics as a child than with the actual severity of the tics.^ Another is reason is because parents don’t punish their kids no more, because they’re afraid of going to jail or having the child called DFACS on them.
  • Atlanta health, diet and fitness news | ajc.com 20 September 2009 1:30 UTC www.ajc.com [Source type: General]

^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The tics occur many times a day, nearly every day, or intermittently throughout a period of more than 1 year.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.A person who was misunderstood, punished, or teased at home or at school will fare worse than children who enjoyed an understanding and supportive environment.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ They are also responsible for supporting persons who do not get the meeting until they have the opportunity of getting one.
  • WRA Boarding School Information for Troubled Teen Consultants 20 September 2009 1:30 UTC www.teenhelponline.com [Source type: FILTERED WITH BAYES]

^ Elementary … teachers report that children are using more offensive language at school than they have in the past,’ said Jay.” .
  • Atlanta health, diet and fitness news | ajc.com 20 September 2009 1:30 UTC www.ajc.com [Source type: General]

[8]

Epidemiology

.Tourette syndrome is found among all social, racial and ethnic groups,[3] has been reported in all parts of the world,[66] and is three to four times more frequent among males than among females.^ The cause of Tourette Syndrome has not been found.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Males are affected three to four times more often than females.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ There is no one medication that is helpful to all people with Tourette Syndrome, nor does any medication completely eliminate symptoms.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

[67] .The tics of Tourette syndrome begin in childhood and tend to remit or subside with maturity; thus, a diagnosis may no longer be warranted for many adults, and prevalence is much higher among children than adults.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Use of levetiracetam to treat tics in children and adolescents with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[26] .Children are five to twelve times more likely than adults to be identified as having tic disorders;[68] as many as 1 in 100 people experience tic disorders, including chronic tics and transient tics in childhood.^ Maybe that is a translation for transient tics or the like.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Yes, it is possible to have more than on tic at a time.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Boys are more likely than girls to have chronic tics.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[3] .The emerging consensus is that 1–10 children per 1,000 have Tourette's,[2] with several studies supporting a tighter range of 6–8 children per 1,000.[4] Using year 2000 census data, a prevalence range of 1–10 per 1,000 yields an estimate of 53,000–530,000 school-age children with Tourette's in the US,[4] and a prevalence estimate of 10 per 1,000 means that in 2001 about 553,000 people in the UK age 5 or older would have Tourette's.^ About 30,000 people ..
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ Earlier studies offered a range of estimates of Tourette’s from less than 1 per 1,000 to close to 30.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ ATLANTA (AP) — Tourette syndrome occurs in 3 out of every 1,000 school-aged children, and is more than twice as common in white kids as in blacks or Hispanics, according to the largest U.S. study to estimate how many have the disorder.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.Most cases would be mild and almost unrecognizable in older individuals.^ When mild cases progress to moderate or severe, it is highly likely that most (if not all) of the symptoms will be present.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The separation anxiety disorder diagnosis is most often applicable to the mild and moderate cases of PAS. In the severe cases, the anxiety element is less operative than the anger element.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ In a sense, most of the moderate, and even some of the mild cases of PAS, are examples of the folie à deux phenomenon.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[66]
.Tourette's is associated with several comorbid conditions, or co-occurring diagnoses, which are often the major source of impairment for an affected child.^ Often, after prolonged forced suppression, a rebound of tic severity occurs, though this is hard to demonstrate in controlled settings.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Association of cortical disinhibition with tic, ADHD, and OCD severity in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tics most often occur in the face, neck, pharynx, shoulders, and midline torso but can affect nearly any body part (see image below).
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[22] .Among patients whose symptoms are severe enough to warrant referral to specialty Tourette's clinics, only a small minority have no other conditions,[69] and obsessive–compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) are often present.^ Other neurobehavioral manifestations include attention-deficit-hyperactivity disorder, obsessive-compulsive disorder, poor impulse control, and other behavioral problems.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Obsessive Compulsive Disorder (OCD) is usually inherited.

^ Brain morphometry in Tourette''s syndrome: the influence of comorbid attention-deficit/hyperactivity disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[22][28] .In children with Tourette's, ADHD is associated with functional impairment, disruptive behavior, and tic severity.^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Their findings show that while Tourette and ADHD have a major genetic component, there are potentially preventable perinatal factors that increase the risk of a co-occurring diagnosis of ADHD in children with Tourette.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The most frequent co-occurring condition in people with Tourette is attention deficit hyperactivity disorder (ADHD), though the cause of this association is uncertain.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

.Other comorbid conditions include self-injurious behaviors (SIB), anxiety, depression, personality disorders, oppositional defiant disorder, and conduct disorders.^ In contrast, the child with a separation anxiety disorder has fears that focus on school but which have spread to many other situations and destinations.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Under such circumstances, the child may respond with anxiety, depression, and disturbances of conduct.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Associated conditions can include attention-deficit hyperactivity disorder (also called ADHD), obsessive-compulsive disorder (OCD), impulsiveness and learning disabilities.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[69] .One author reports that a ten-year overview of patient records revealed about 40% of patients with Tourette's have "TS-only" or "pure TS", referring to Tourette syndrome in the absence of ADHD, OCD and other disorders.^ Tourette syndrome misconceptions only one battle for patients .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ "Earlier reports suggested beneficial effects in Tourette's syndrome when smoking marijuana," the German research team wrote.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

[29][30]
.Tourette syndrome was once thought to be rare: in 1972, the US National Institutes of Health (NIH) believed there were fewer than 100 cases in the United States,[70] and a 1973 registry reported only 485 cases worldwide.^ Researchers stated, "This is the first report of a successful treatment of Tourette's syndrome with delta-9-THC." They said they are planning to confirm their preliminary results in an upcoming double-blind, placebo controlled, crossover study.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ "Earlier reports suggested beneficial effects in Tourette's syndrome when smoking marijuana," the German research team wrote.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ CDC study: Tourette syndrome is rare; more common in boys and white children .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[71] .However, multiple studies published since 2000 have consistently demonstrated that the prevalence is much higher than previously thought.^ Neuropathological studies, however, have failed to reveal any consistent structural abnormalities in these areas.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Some but not all other studies of patients with TS have shown higher than normal commission errors on response inhibition tasks.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ However studies have failed to demonstrate abnormal concentrations of norepinephrine or its metabolites in serum, CSF and urine in patients with TS. .
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[72] .Discrepancies across current and prior prevalence estimates come from several factors: ascertainment bias in earlier samples drawn from clinically referred cases, assessment methods that may fail to detect milder cases, and differences in diagnostic criteria and thresholds.^ Approximately 20% in clinical samples, more closely associated with comorbid ADHD than with tics; also associated with male sex, earlier onset, severity, perinatal problems, and lower rates in family members 112 .
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Furthermore, in the course of protracted litigation, a patient may move along the track from the milder to a more severe disorder on this continuum.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Coprolalia Coprolalia refers to unprovoked, unwanted outbursts of obscenities and occurs in 10-40% of patients with TS, depending on the method of ascertainment.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[73] .There were few broad-based community studies published before 2000 and until the 1980s, most epidemiological studies of Tourette syndrome were based on individuals referred to tertiary care or specialty clinics.^ A twin study of Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ CDC study: Tourette syndrome is rare; more common in boys and white children .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The functional neuroanatomy of Tourette''s syndrome: an FDG-PET Study.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[1][74] .Children with milder symptoms are unlikely to be referred to specialty clinics, so these studies have an inherent bias towards more severe cases.^ Repeat studies in the same children replicated these findings and demonstrated their temporal stability.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ In Tourette's 1885 paper, Study of a Nervous Affliction, he concluded that these patients suffered from a new clinical condition: "convulsive tic disorder."
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Other people with TS have more severe symptoms.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[1][75] .Studies of Tourette syndrome are vulnerable to error because tics vary in intensity and expression, are often intermittent, and are not always recognized by clinicians, patients, family members, friends or teachers;[6][76] approximately 20% of persons with Tourette syndrome do not recognize that they have tics.^ A twin study of Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[6] .Recent studies—recognizing that tics may often be undiagnosed and hard to detect—use direct classroom observation and multiple informants (parent, teacher, and trained observers), and therefore record more cases than older studies relying on referrals.^ The separation anxiety disorder diagnosis is most often applicable to the mild and moderate cases of PAS. In the severe cases, the anxiety element is less operative than the anger element.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ In some cases, then, it may be even worse than other forms of abuse, e.g., physical abuse, sexual abuse, and neglect.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Parents or guardians in more than 91,000 U.S. households were interviewed by phone, and asked if a doctor had ever told them that their child had Tourette syndrome.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[51][77] As the diagnostic threshold and assessment methodology have moved towards recognition of milder cases, the result is an increase in estimated prevalence.[73]

History and research directions

.
A woman faints into the arms of a man standing behind her, with another woman, apparently a nurse, reaching to help.</span><span class=^ Kushner HI. A Cursing Brain--The Histories of Tourette Syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

An older man stands beside her, gesturing as if making a point; another man behind him takes notes at a desk." src="http://images-mediawiki-sites.thefullwiki.org/09/1/3/5/9093692073390623.jpg" width="170" height="257" class="thumbimage" />
.
Jean-Martin Charcot (1825–1893) was a French neurologist and professor who bestowed the eponym for Tourette syndrome on behalf of his resident, Georges Albert Édouard Brutus Gilles de la Tourette.
^ Bliss J. Sensory experiences of Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Movement control of manipulative tasks in patients with Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Brain perfusion abnormalities in Gilles de la Tourette''s syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

Charcot is shown here during a lesson with a "hysterical" woman patient at the Salpêtrière hospital.
.The first presentation of Tourette syndrome is thought to be in a 1489 book, Malleus maleficarum ("Witch's hammer") by Jakob Sprenger and Heinrich Kraemer, describing a priest whose tics were "believed to be related to possession by the devil".[78] A French doctor, Jean Marc Gaspard Itard, reported the first case of Tourette syndrome in 1825,[79] describing Marquise de Dampierre, an important woman of nobility in her time.^ Asperger first described his syndrome in 1957.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Gille de La Tourette first described his syndrome in 1885.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[12] .Jean-Martin Charcot, an influential French physician, assigned his resident Georges Albert Édouard Brutus Gilles de la Tourette, a French physician and neurologist, to study patients at the Salpêtrière Hospital, with the goal of defining an illness distinct from hysteria and from chorea.^ People with OCD can also have Tic Disorders or Gilles de la Tourette Disorder.

^ Gille de La Tourette first described his syndrome in 1885.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ With this bit: "In a remarkable series of papers by Comings and Comings in the Journal, a number of claims are made that have profound implications for future research on Gilles de la Tourette syndrome (TS).
  • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

[25]
.In 1885, Gilles de la Tourette published an account of nine patients, Study of a Nervous Affliction, concluding that a new clinical category should be defined.^ Bliss J. Sensory experiences of Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Movement control of manipulative tasks in patients with Gilles de la Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Brain perfusion abnormalities in Gilles de la Tourette''s syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[80] .The eponym was later bestowed by Charcot after and on behalf of Gilles de la Tourette.^ People with OCD can also have Tic Disorders or Gilles de la Tourette Disorder.

^ Gille de La Tourette first described his syndrome in 1885.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ With this bit: "In a remarkable series of papers by Comings and Comings in the Journal, a number of claims are made that have profound implications for future research on Gilles de la Tourette syndrome (TS).
  • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

[25][81]
.Little progress was made over the next century in explaining or treating tics, and a psychogenic view prevailed well into the 20th century.^ Over the next century, little progress was made with respect to pathogenesis.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Should I expect to see a progression of tics, with each bout more severe and complex than the next?
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ In the US, the view that TS was a rare, bizarre psychological disorder prevailed for much of the 20th century.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[25] .The possibility that movement disorders, including Tourette syndrome, might have an organic origin was raised when an encephalitis epidemic from 1918–1926 led to a subsequent epidemic of tic disorders.^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ CLOSE WINDOW ] Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[82]
.During the 1960s and 1970s, as the beneficial effects of haloperidol (Haldol) on tics became known, the psychoanalytic approach to Tourette syndrome was questioned.^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ A functional neuroanatomy of tics in Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ "Earlier reports suggested beneficial effects in Tourette's syndrome when smoking marijuana," the German research team wrote.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

[83] .The turning point came in 1965, when Arthur K. Shapiro—described as "the father of modern tic disorder research"[84]—treated a Tourette’s patient with haloperidol, and published a paper criticizing the psychoanalytic approach.^ Tourette syndrome and other tic disorders.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ The researchers found that a 25-year-old patient treated with 10 mg of THC experienced marked improvement of both vocal and motor tics associated with behavioral disorders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

[82]
.Since the 1990s, a more neutral view of Tourette's has emerged, in which biological vulnerability and adverse environmental events are seen to interact.^ To view the manuscript, view photos and get more information on Tourette syndrome, please visit our media room: http://medicine.ucalgary.ca/mediaroom/tourette/pringsheim .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Also, interestingly enough, more kids have Tourettes then are diagnosed since often times it’s not that dramatic in appearance.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[6][25] .In 2000, the American Psychiatric Association published the DSM-IV-TR, revising the text of DSM-IV to no longer require that symptoms of tic disorders cause distress or impair functioning.^ DSM-IV was published in 1994.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ As a result, some individuals may actually become symptom free or no longer need medication for tic suppression.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ Because tic symptoms do not often cause impairment, the majority of people with Tourette Syndrome require no medication for tic suppression.However, effective medications are available for those whose symptoms interfere with functioning.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

[85]
Findings since 1999 have advanced TS science in the areas of genetics, neuroimaging, neurophysiology, and neuropathology. .Questions remain regarding how best to classify Tourette syndrome, and how closely Tourette's is related to other movement disorders or psychiatric disorders.^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ Pechman gave Soloway at least 60 days to report for imprisonment so that he can resolve problems with medication for Tourette's disorder, which is characterized by involuntary movements and verbal outbursts.
  • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

^ It was not until 1980, 95 years later, that the disorder found its way into the DSM. It is important to note that at that point, Tourette’s Syndrome became Tourette’s Disorder.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

Good epidemiologic data is still lacking, and available treatments are not risk free and not always well tolerated.[86] .High-profile media coverage focuses on treatments that do not have established safety or efficacy, such as deep brain stimulation, and alternative therapies involving unstudied efficacy and side effects are pursued by many parents.^ Lactose_Intolerance_Symptoms.html Levitra Side Effects - Levitra Withdrawls Levitra is a medicine taken by mouth for the treatment of erectile dysfunction (ED) in men.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ I am a teacher-having worked with so many kids and now having my own, I know how food can have such a huge effect on kids(and adults for that matter!
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

^ Scientists may discover such drugs and procedures using alternative research methods that do not involve animals.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

[39]

Society and culture

Half-length portrait of a large, squinting man with a fleshy face, dressed in brown and wearing an 18th-century wig
Samuel Johnson (1709–1784) circa 1772. Johnson had Tourette syndrome.
Not everyone with Tourette's wants treatment or a "cure", especially if that means they may "lose" something else in the process.[87][88] .Some people believe that there may be latent advantages associated with genetic vulnerability to the syndrome.^ Examiners may have different opinions regarding the etiology and treatment of a particular psychiatric disorder, but there is usually some consensus about its existence.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Some people may not find out they have it until they have trouble with their heart, brain, or kidneys.
  • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ It is believed that Tourette syndrome affects about 1 in 100 people; however, many people do not seek medical attention for the disorder because the symptoms are so mild.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[88] .There is evidence to support the clinical lore that children with "TS-only" (Tourette's in the absence of comorbid conditions) are unusually gifted: neuropsychological studies have identified advantages in children with TS-only.^ CDC study: Tourette syndrome is rare; more common in boys and white children .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Ziprasidone treatment of children and adolescents with Tourette''s syndrome: a pilot study.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ In Tourette's 1885 paper, Study of a Nervous Affliction, he concluded that these patients suffered from a new clinical condition: "convulsive tic disorder."
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[30][89] .One study found that children with TS-only are faster than the average for their age group on timed motor coordination.^ I personally prefer to promote group work but let each student find their own groups naturally This can be promoted by a story about two heads being better than one..

^ A person with TS has about a 50 percent chance of passing the gene to one of his/her children with each separate pregnancy.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ The proportion of red hair individuals in this study were significantly higher than five of the eight population control groups, with 22 (13%) of the respondents having red hair.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[90]
.Notable individuals with Tourette syndrome are found in all walks of life, including musicians, athletes and authors.^ Immunologic response found in patients with Sydenham chorea is also found in patients with Tourette syndrome and obsessive-compulsive disorder.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Altered parvalbumin-positive neuron distribution in basal ganglia of individuals with Tourette syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

.The best-known example of a person who may have used obsessive–compulsive traits to advantage is Dr Samuel Johnson, the 18th-century English man of letters, who had Tourette syndrome as clearly evidenced by the writings of James Boswell.^ Many with Tourette Syndrome experience additional neurobehavioral problems including inattention, hyperactivity and impulsivity, and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors.
  • Symptoms Of Tourettes Syndrome 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

^ A historical example of TS is provided by Samuel Johnson (1709-1784), the author of the first good English dictionary and the subject of Boswell's biography.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

^ Woods DW, Marcks BA. Controlled evaluation of an educational intervention used to modify peer attitudes and behavior toward persons with Tourette's Syndrome.
  • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

[91][92] Johnson wrote A Dictionary of the English Language in 1747, and was a prolific writer, poet, and critic.
.Although it has been speculated that Mozart had Tourette's,[93][94] no Tourette's expert or organization has presented credible evidence to show that this was the case,[94] and there are problems with the available data.^ There is no measurable improvement on academic achievement given the technology availability.

^ If there's no soccer on, or if I'm not interested in the Daily Show's current features, it's been tuned to the Food Network.
  • Appetites: An Open Letter to the Food Network 20 September 2009 1:30 UTC www.appetites.us [Source type: FILTERED WITH BAYES]

^ As it turns out, the media has really done a disservice to Tourettes, showing only the worse case scenarios.
  • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

[95]
.The entertainment industry has been criticized for depicting those with Tourette syndrome as social misfits whose only tic is coprolalia, which has furthered stigmatization and the public's misunderstanding of those with Tourette's.^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
  • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

^ Tourette syndrome misconceptions only one battle for patients .
  • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

[96] The coprolalic symptoms of Tourette's are also fodder for radio and television talk shows in the US[97] and in the British media.[98]

Notes

  1. ^ a b c d Schapiro NA. "Dude, you don't have Tourette's:" Tourette's syndrome, beyond the tics. Pediatr Nurs. 2002 May–Jun;28(3):243–6, 249–53. PMID 12087644 Full text (free registration required).
  2. ^ a b Lombroso PJ, Scahill L. "Tourette syndrome and obsessive–compulsive disorder". Brain Dev. 2008 Apr;30(4):231–7. PMID 17937978
  3. ^ a b c d Tourette Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke/National Institutes of Health (NINDS/NIH), February 14, 2007. Retrieved on May 14, 2007.
  4. ^ a b c d Scahill L, Williams S, Schwab-Stone M, Applegate J, Leckman JF. "Disruptive behavior problems in a community sample of children with tic disorders". Adv Neurol. 2006;99:184–90. PMID 16536365
  5. ^ Portraits of adults with TS. Tourette Syndrome Association. Retrieved on January 4, 2007.
  6. ^ a b c d e f g h i j k l m n o p q r s t Zinner (2000).
  7. ^ Peterson BS, Cohen DJ. "The treatment of Tourette's Syndrome: multimodal, developmental intervention". J Clin Psychiatry. 1998;59 Suppl 1:62–72; discussion 73–4. PMID 9448671. Quote: "Because of the understanding and hope that it provides, education is also the single most important treatment modality that we have in TS."
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    * Hoekstra PJ, Steenhuis MP, Troost PW, et al. "Relative contribution of attention-deficit hyperactivity disorder, obsessive–compulsive disorder, and tic severity to social and behavioral problems in tic disorders". J Dev Behav Pediatr. 2004 Aug;25(4):272–79. PMID 15308928
    * Carter AS, O'Donnell DA, Schultz RT, et al. "Social and emotional adjustment in children affected with Gilles de la Tourette's syndrome: associations with ADHD and family functioning. Attention Deficit Hyperactivity Disorder". J Child Psychol Psychiatry. 2000 Feb;41(2):215–23. PMID 10750547
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  61. ^ a b Pappert EJ, Goetz CG, Louis ED, et al. "Objective assessments of longitudinal outcome in Gilles de la Tourette's syndrome." Neurology. 2003 Oct 14;61(7):936–40. PMID 14557563
  62. ^ Burd L, Kerbeshian PJ, Barth A, et al. "Long-term follow-up of an epidemiologically defined cohort of patients with Tourette syndrome". J Child Neurol. 2001;16(6):431–37. PMID 11417610
  63. ^ Soccer Goalie with Tourette Syndrome Gains International Attention as Role Model. Tourette Syndrome Association press release, July 25, 2003. Retrieved on March 1, 2008.
  64. ^ Leckman & Cohen (1999), p. 37. "For example, individuals who were misunderstood and punished at home and at school for their tics or who were teased mercilessly by peers and stigmatized by their communities will fare worse than a child whose interpersonal environment was more understanding and supportive."
  65. ^ Cohen DJ, Leckman JF, Pauls D. "Neuropsychiatric disorders of childhood: Tourette’s syndrome as a model". Acta Paediatr Suppl 422; 106–11, Scandinavian University Press, 1997. "The individuals with TS who do the best, we believe, are: those who have been able to feel relatively good about themselves and remain close to their families; those who have the capacity for humor and for friendship; those who are less burdened by troubles with attention and behavior, particularly aggression; and those who have not had development derailed by medication."
  66. ^ a b Robertson MM. "The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 1: the epidemiological and prevalence studies". J Psychosom Res. 2008 Nov;65(5):461–72. PMID 18940377
  67. ^ Bagheri, Kerbeshian and Burd (1999) report that TS is "three to nine times more frequent in males than in females". Zinner (2000) says, "Data from most studies suggest ... [a] male:female ratio typically ranging from 2:1 to 4:1." Leckman & Cohen (1999), p. 180, Table 10.1 report a range based on six studies of 1.6:1 to 9.3:1 male:female ratio. Robertson part 1 (2008), p. 465 says, "All studies agree that GTS occurs more in males than in females, with a figure of approximately 4:1." The most commonly reported ratio (3:1 to 4:1) is from the Tourette Syndrome Association's "What is Tourette syndrome?" and the NINDS/NIH Tourette Syndrome Fact Sheet.
  68. ^ Leckman JF, Peterson BS, Pauls DL, Cohen DJ. "Tic disorders". Psychiatr Clin North Am. 1997 Dec;20(4):839–61. PMID 9443353
  69. ^ a b Robertson MM. "The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 2: tentative explanations for differing prevalence figures in GTS, including the possible effects of psychopathology, aetiology, cultural differences, and differing phenotypes". J Psychosom Res. 2008 Nov;65(5):473–86. PMID 18940378
  70. ^ Cohen DJ, Jankovic J, Goetz CG, (eds). Advances in neurology, Vol. 85, Tourette syndrome. Lippincott, Williams & Wilkins, Philadelphia, PA, 2001, p. xviii. ISBN 0-7817-2405-8
  71. ^ Abuzzahab FE, Anderson FO. "Gilles de la Tourette's syndrome; international registry". Minnesota Medicine. 1973 Jun;56(6):492–6. PMID 4514275
  72. ^ Scahill, L. "Epidemiology of Tic Disorders". Medical Letter: 2004 Retrospective Summary of TS Literature. Tourette Syndrome Association. The first page (PDF), is available without subscription. Retrieved on June 11, 2007.
    * Kadesjö B, Gillberg C. "Tourette's disorder: epidemiology and comorbidity in primary school children". J Am Acad Child Adolesc Psychiatry. 2000 May;39(5):548–55. PMID 10802971
    * Kurlan R, McDermott MP, Deeley C, et al. "Prevalence of tics in schoolchildren and association with placement in special education". Neurology. 2001 Oct 23;57(8):1383–8. PMID 11673576
    * Khalifa N, von Knorring AL. "Prevalence of tic disorders and Tourette syndrome in a Swedish school population". Dev Med Child Neurol. 2003 May;45(5):315–19. PMID 12729145
    * Hornsey H, Banerjee S, Zeitlin H, Robertson M. "The prevalence of Tourette syndrome in 13–14-year-olds in mainstream schools". J Child Psychol Psychiatry. 2001 Nov;42(8):1035–39. PMID 11806685
  73. ^ a b Scahill, L. "Epidemiology of Tic Disorders". Medical Letter: 2004 Retrospective Summary of TS Literature. Tourette Syndrome Association. The first page (PDF), is available without subscription. Retrieved on June 11, 2007.
  74. ^ Zohar AH, Apter A, King RA et al. "Epidemiological studies". In J.F. Leckman & D.J. Cohen (Eds.), Tourette's syndrome – tics, obsessions, compulsions: Developmental psychopathology and clinical care (pp. 177–92). Wiley & Sons, 1999. ISBN 0-471-16037-7
  75. ^ Coffey BJ, Park KS. "Behavioral and emotional aspects of Tourette syndrome". Neurol Clin. 1997 May;15(2):277–89. PMID 9115461
  76. ^ Hawley, JS. Tourette Syndrome. eMedicine (June 23, 2008). Retrieved on August 10, 2009.
  77. ^ Leckman JF. "Tourette's syndrome". Lancet. 2002 Nov 16;360(9345):1577–86. PMID 12443611
  78. ^ Teive HA, Chien HF, Munhoz RP, Barbosa ER. "Charcot's contribution to the study of Tourette's syndrome". Arq Neuropsiquiatr. 2008 Dec;66(4):918–21. PMID 19099145 as reported in Finger S. "Some movement disorders." In Finger S (ed). Origins of neuroscience: the history of explorations into brain function. New York: Oxford University Press, 1994:220–239.
  79. ^ Itard JMG. "Mémoire sur quelques functions involontaires des appareils de la locomotion, de la préhension et de la voix". Arch Gen Med. 1825;8:385–407. From Newman, Sara. "Study of several involuntary functions of the apparatus of movement, gripping, and voice" by Jean-Marc Gaspard Itard (1825) History of Psychiatry. 2006 17: 333–39. doi:10.1177/0957154X06067668
  80. ^ Gilles de la Tourette G, Goetz CG, Llawans HL, trans. "Étude sur une affection nerveuse caractérisée par de l'incoordination motrice accompagnée d'echolalie et de coprolalie". In: Friedhoff AJ, Chase TN, eds. Advances in Neurology: Volume 35. Gilles de la Tourette syndrome. New York: Raven Press; 1982;1–16. Discussed at Black, KJ. Tourette Syndrome and Other Tic Disorders. eMedicine (March 30, 2007). Retrieved on August 10, 2009. Original text (in French). Retrieved on August 10, 2009.
  81. ^ Enersen, Ole Daniel. Georges Albert Édouard Brutus Gilles de la Tourette. WhoNamedIt.com Retrieved on May 14, 2007.
  82. ^ a b Blue, Tina. Tourette syndrome. Essortment 2002. Pagewise Inc. Retrieved on August 10, 2009.
  83. ^ Rickards H, Hartley N, Robertson MM. "Seignot's paper on the treatment of Tourette's syndrome with haloperidol. Classic Text No. 31". Hist Psychiatry. 1997 Sep;8 (31 Pt 3):433–36. PMID 11619589
  84. ^ Gadow KD, Sverd J. "Attention deficit hyperactivity disorder, chronic tic disorder, and methylphenidate". Adv Neurol. 2006;99:197–207. PMID 16536367
  85. ^ What is DSM-IV-TR? Psychnet-UK. Retrieved on May 14, 2007.
  86. ^ Walkup JT, Mink JW, Hollenback PJ, (eds). (2006) pp. xvi–xviii
  87. ^ Sacks, O (1985). The man who mistook his wife for a hat: and other clinical tales. Harper and Row, New York, pp. 92–100. ISBN 0-684-85394-9
  88. ^ a b Leckman & Cohen (1999), p. 408. ISBN 0-471-16037-7
  89. ^ Schuerholz LJ, Baumgardner TL, Singer HS, et al. "Neuropsychological status of children with Tourette's syndrome with and without attention deficit hyperactivity disorder". Neurology. 1996 Apr;46(4):958–65. PMID 8780072
  90. ^ Schuerholz LJ, Cutting L, Mazzocco MM, et al. "Neuromotor functioning in children with Tourette syndrome with and without attention deficit hyperactivity disorder". J Child Neurol. 1997 Oct;12(7):438–42. PMID 9373800
  91. ^ Samuel Johnson. Tourette Syndrome Association. Archived April 7, 2005.
  92. ^ Pearce JM. "Doctor Samuel Johnson: 'the great convulsionary' a victim of Gilles de la Tourette's syndrome" (PDF). Journal of the Royal Society of Medicine. 1994 Jul;87(7):396–9. PMID 8046726
  93. ^ Simkin, Benjamin. Medical and Musical Byways of Mozartiana. Fithian Press, 2001. ISBN 1-56474-349-7 Review, Retrieved on May 14, 2007.
    * Simkin B. "Mozart's scatological disorder". BMJ. 1992 Dec 19–26;305(6868):1563–7. PMID 1286388
  94. ^ a b Did Mozart really have TS? Tourette Syndrome Association. Archived April 7, 2005.
  95. ^ Kammer T. "Mozart in the neurological department—who has the tic?" (PDF). Front Neurol Neurosci. 2007;22:184–92. PMID 17495512 doi:10.1159/0000102880 Retrieved on September 10, 2007
    * Ashoori A, Jankovic J. "Mozart's movements and behaviour: a case of Tourette's syndrome?" J Neurol Neurosurg Psychiatry. 2007 Nov;78(11):1171–5 doi:10.1136/jnnp.2007.114520 PMID 17940168.
    * Sacks O. "Tourette's syndrome and creativity". BMJ. 1992 Dec 19–26;305(6868):1515–6. PMID 1286364
  96. ^ Holtgren, Bruce. "Truth about Tourette's not what you think". Cincinnati Enquirer (January 11, 2006). "As medical problems go, Tourette's is, except in the most severe cases, about the most minor imaginable thing to have. ... the freak-show image, unfortunately, still prevails overwhelmingly. The blame for the warped perceptions lies overwhelmingly with the video media – the Internet, movies and TV. If you search for 'Tourette' on Google or YouTube, you'll get a gazillion hits that almost invariably show the most outrageously extreme examples of motor and vocal tics. Television, with notable exceptions such as Oprah, has sensationalized Tourette's so badly, for so long, that it seems beyond hope that most people will ever know the more prosaic truth."
  97. ^ Oprah and Dr. Laura – Conflicting Messages on Tourette Syndrome. Oprah Educates; Dr. Laura Fosters Myth of TS as "Cursing Disorder". Tourette Syndrome Association (May 31, 2001). Archived October 6, 2001.
    * Letter of response to Dr. Phil. Tourette Syndrome Association. Retrieved on May 8, 2006.
    * Letter of response to Garrison Keillor radio show. Tourette Syndrome Association. Retrieved on May 8, 2006.
    * Big Brother: Tourette's housemate 'exploited'. Mail online, (May 19, 2006). Retrieved on September 19, 2008.
  98. ^ Guldberg, Helene. Stop celebrating Tourette's. Spiked (May 26, 2006). Retrieved on December 26, 2006.

References

.
  • Bagheri MM, Kerbeshian J, Burd L. "Recognition and management of Tourette's syndrome and tic disorders". American Family Physician.^ Tourette's syndrome is a complex neuropsychiatric disorder that is characterized by sudden spasms, so called "tics," that occur especially in the face, neck, and shoulders.
    • Marijuana Successfully Treats Tourette's Syndrome, Study Shows - NORML 28 January 2010 1:01 UTC norml.org [Source type: News]

    ^ The family needs to contact the Tourette Syndrome Association (888-4-TOURET; www.tsa-usa.org).
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ Less than half of those who have Tourette Syndrome as children have moderate to severe tics as adults.
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    .1999; 59:2263–74. PMID 10221310 Retrieved on October 28, 2006.
  • Leckman JF, Cohen DJ. Tourette's Syndrome—Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. John Wiley & Sons, Inc., New York, 1999. ISBN 0-471-16037-7 Outline. Retrieved on October 28, 2006.
  • Robertson MM. "Tourette syndrome, associated conditions and the complexities of treatment" (PDF).^ Tics were not affected by treatment in the blinded condition.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    ^ Association between streptococcal infection and obsessive-compulsive disorder, Tourette's syndrome, and tic disorder.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    ^ Tourette syndrome and other tic disorders.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    Brain. .2000;123 Pt 3:425–62. PMID 10686169 Retrieved on January 25, 2007.
  • Tourette Syndrome: Frequently Asked Questions. Tourette Syndrome Association.^ The family needs to contact the Tourette Syndrome Association (888-4-TOURET; www.tsa-usa.org).
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ In association with this burgeoning of child-custody litigation, we have witnessed a dramatic increase in the frequency of a disorder rarely seen previously, a disorder that I refer to as the parental alienation syndrome (PAS).
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ Parents or guardians in more than 91,000 U.S. households were interviewed by phone, and asked if a doctor had ever told them that their child had Tourette syndrome.
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    .Retrieved on January 6, 2006.
  • What is Tourette syndrome? Tourette Syndrome Association.^ Dopamine receptor D2 gene polymorphisms are associated in Taiwanese children with Tourette syndrome.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    ^ The family needs to contact the Tourette Syndrome Association (888-4-TOURET; www.tsa-usa.org).
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ Sequence variants in SLITRK1 are associated with Tourette's syndrome.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    .Archived May 24, 2006.
  • The Tourette Syndrome Classification Study Group.^ CDC study: Tourette syndrome is rare; more common in boys and white children .
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ There could be a link between having red hair and Tourette syndrome, says a new study from the University of New South Wales.
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ By Paul G. Donohue M.D. To Your Good Health May 08, 2009 6:00 AM DEAR DR. DONOHUE: My grandson was diagnosed with Tourette’s syndrome at age 10.
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ."Definitions and classification of tic disorders". Arch Neurol. 1993 Oct;50(10):1013–16. PMID 8215958 Archived April 26, 2006.
  • Walkup, JT, Mink, JW, Hollenback, PJ, (eds).^ Definitions and classification of tic disorders.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    ^ Sept 2006 to: 10 october then from: 16 October 2006 to: 16 November 2006 then again from: 19 November 2006 to: 24 November 2006 then again (fun eh): from: 25 November 2006 to: 27 November 2006 then...
    • Bob Soloway the spammer spamming a domain owner 16 September 2009 13:16 UTC sjwest01.googlepages.com [Source type: FILTERED WITH BAYES]

    ^ Diagnostic criteria for definite tic disorder, diagnosis deferred F: This disorder meets all criteria for definite TS (first definition, A1), but duration of illness has not yet extended to 1 year.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    Advances in Neurology, Vol. .99, Tourette syndrome. Lippincott, Williams & Wilkins, Philadelphia, PA, 2006. ISBN 0-7817-9970-8
  • Zinner SH. "Tourette disorder". Pediatr Rev.^ It was not until 1980, 95 years later, that the disorder found its way into the DSM. It is important to note that at that point, Tourette’s Syndrome became Tourette’s Disorder.
    • Tourette's Syndrome 6 February 2010 13:47 UTC tsblog.org [Source type: FILTERED WITH BAYES]

    ^ Rates for tic disorders and obsessive compulsive symptomatology in families of children and adolescents with Gilles de la Tourette syndrome.
    • Tourette Syndrome and Other Tic Disorders: eMedicine Neurology 6 February 2010 13:47 UTC emedicine.medscape.com [Source type: Academic]

    ^ I left out the wording “Tourette Syndrome” as we didn’t have that diagnosis yet, and just used Tic Disorder instead.
    • BabyCenter: MOMformation » Blog Archive » Tics, Tourettes and food allergies 6 February 2010 13:47 UTC blogs.babycenter.com [Source type: General]

    2000;21(11):372–83. PMID 11077021

Further reading

External links

.

Wiktionary

Up to date as of January 15, 2010

Definition from Wiktionary, a free dictionary

Contents

English

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Wikipedia has an article on:

Noun

Singular
Tourette syndrome
Tourette syndrome (uncountable)
.
  1. A neurological disorder characterized by the presence of physical and vocal tics.^ Treatment of ADHD in the presence of tic disorders .
    • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

    ^ Tourette Syndrome Foundation of Canada (TSFC) Tourette Syndrome is a neurological disorder characterized by tics - involuntary, rapid, sudden movement or vocalizations that occur repeatedly in the same way.
    • Tourette Syndrome : Online Pharmacy : Health Medical Information : MedExplorer - Pharmacy, Health, Medical Directory Since '95 6 February 2010 13:47 UTC www.medexplorer.com [Source type: Academic]

    ^ Tourette syndrome (also called Tourette's syndrome, Tourette's disorder, Gilles de la Tourette syndrome, GTS or the more common Tourette's or TS) is an inherited neurological disorder with onset in childhood, characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane.
    • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]

    • 1999, Breslin M.A., editor. .Enforcing the Civil Rights of Air Travelers With Disabilities: Recommendations for the Department of Transportation and Congress. National Council on Disability, Washington, DC, p.^ Card_Summer_Camp_Locations_YMCA.html Learn About The YWCA The YWCA provides safe places for women and girls, build strong women leaders, and advocate for women's rights and civil rights in Congress...
      • Site Map 15 September 2009 4:26 UTC www.iifar.org [Source type: Academic]

      8,
      .Tourette syndrome is a condition characterized by involuntary vocalizations exacerbated by stress.^ Tics are involuntary, sudden, rapid, brief, repetitive, and stereotyped movements or vocalizations (12) which are enhanced by anxiety, anger, stress and fatigue (6).
      • Gilles de la Tourette's Syndrome: Genetics and Dopamine [MJM 1997 3: 29-35] 28 January 2010 1:01 UTC www.medicine.mcgill.ca [Source type: Academic]

      ^ Chorea is characterized by involuntary movements that travel between body parts in a random, unpredictable fashion, whereas Tourette's syndrome involves a number of discrete tics or tic patterns that are repeated in a predictable and stereotypic manner.
      • Tourette's Syndrome - March 1, 2008 - American Family Physician 28 January 2010 1:01 UTC www.aafp.org [Source type: Academic]

      ^ Tourette Syndrome Foundation of Canada (TSFC) Tourette Syndrome is a neurological disorder characterized by tics - involuntary, rapid, sudden movement or vocalizations that occur repeatedly in the same way.
      • Tourette Syndrome : Online Pharmacy : Health Medical Information : MedExplorer - Pharmacy, Health, Medical Directory Since '95 6 February 2010 13:47 UTC www.medexplorer.com [Source type: Academic]

Usage notes

.Modern editors often prefer the non-possessive form of medical eponyms, rather than the older Tourette's syndrome.^ With the increased knowledge of the full range of symptomatology of Tourette's syndrome, it has shifted from a condition only recognized in its most severe and impairing forms, to being recognized as a condition which is often mild, and which may be associated with some advantages and disadvantages.
  • Gilles de laTourette disorder - Psychology Wiki 6 February 2010 13:47 UTC psychology.wikia.com [Source type: Academic]

^ Differential diagnosis list for Tourette Syndrome may include: Drug abuse Substance-related disorder Stereotypic Movement disorder - rhythmic movements rather than actual tics.
  • Treatments for Tourette Syndrome - WrongDiagnosis.com 28 January 2010 1:01 UTC www.wrongdiagnosis.com [Source type: Academic]

^ In cases where treatment is warranted, treatment of Tourette syndrome can be divided into treatment of tics, and treatment of co-occurring conditions, which, when present, are often a larger source of impairment than the tics themselves.
  • Tourette Syndrome & Tic Disorders Support Group - DailyStrength 28 January 2010 1:01 UTC www.dailystrength.org [Source type: FILTERED WITH BAYES]

Synonyms

Derived terms

Translations

  • Russian: синдром Туретта (sindróm Turétta) m.
  • Swedish: Tourettes syndrom n.

Simple English

Tourette syndrome is an inherited neurological disorder. Tourette syndrome can also be named Tourette's syndrome,Tourette's disorder, Gilles de la Tourette's Syndrome, GTS, Tourette's, or TS. People that have Tourette's have tics (movements or sounds that the person cannot easily control). Tourette's is normally inherited, and starts in childhood.

People who have Tourette's have a normal life expectancy and normal intelligence. Tics are normally not as bad as people get older. Adults with severe Tourette's are rare. Fewer than 15% of people with Tourette's have coprolalia. Coprolalia is using words or phrases that some people might find offensive without being able to stop saying them. These may include curse words.

Most people with Tourette's do not need treatment. There are drugs that can help people manage tics. There are also therapies that can help people live easier with Tourette's.

The disease is named after Georges Gilles de la Tourette. He was one of the first doctors to describe the symptoms.

Other websites


Citable sentences

Up to date as of December 13, 2010

Here are sentences from other pages on Tourette syndrome, which are similar to those in the above article.








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