Turrets is a chronic neurodevelopemental disorder. The first reported case of Tourette Syndrome in medical literature was in 1825, when Jean Marc Gaspard Itard described the case of the Marquise de Dampierre. The Marquise was a noble woman whose symptoms included coprolalia (the utterance of swear words). She regularly shocked her high society friends by yelling out obscenities during conversations.
In 1885, Dr. George Gilles de la Tourette, a French neurologist at l'Hôpital de la Salpêtrière described nine patients with "maladie des tics", citing the Marquise de Dampierre as his primary case example. He described a condition where those affected twitched and jerked uncontrollably. The sufferers also cried out or grunted, or, in the Marquise's case, swore. Dr. George Gilles de la Tourette was a student of Jean-Martin Charcot. Charcot was the director of l'Hôpital de la Salpêtrière and one of the most important and influential neurologists of his day.
Tourette syndrome was initially considered to be a psychological one. The observation in the 1960s that certain drugs called neuroleptics were effective in treating TS, refocused attention from a psychological to an organic central nervous system cause.
Very much like OCD, people with Tourette Syndrome are not psychologically impaired, obstinate, or unintelligent. Most people with the disorder lead normal productive lives, with some of them excelling in their given professions. Those thought to have suffered from TS include Samuel Johnson the lexicographer, and André Malraux, the French author. Mozart, and Manchester United and US goalkeeper, Tim Howard, also recently admitted to suffering from the condition.
What are the symptoms?
Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing c combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering socially inappropriate words such as swearing) or echolalia (repeating the words or phrases of others). However, coprolalia is only present in a small number (10 to 15 percent) of individuals with Turrets Syndrome. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with Turrets will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished.
Although the cause of Turrets is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation
