Tourette's Syndrome Case Study

Tourette’s syndrome, discovered by French physician George Grilled de la Tourette in 1885, is an incurable neuropsychiatric disorder that onsets in childhood and is characterized by “the presence of multiple motor tics and one or more vocal tics, not necessarily concurrently, that last longer than one year.” (Cavanna and Shah, 2010) There are two types of tics; motor and phonic (vocal), which may be simple or complex. “Simple motor tics involve isolated muscles, producing movements such as blinking or sniffing. Complex motor tics involve contractions in different muscle groups and coordinated movements that resemble normal motor gestures.” (Cavanna, 2010). Some of the more complex motor tics are known as echopraxia (repetition of the movement of others) and copropraxia (obscene gestures; affecting less than one-fifth of Tourette’s cases). It is estimated that 35-percent of Tourette patients have vocal tics. Simple vocal tics may include coughing or clearing of the throat. Complex vocal tics include coprolalia (shouting obscenities; affecting less than one-third of Tourette’s cases), palilalia (repetitive noises and words), and

In mild cases, treatment is may be unnecessary. In moderate to severe cases, treatment may include behavioral (habit-reversal) and cognitive therapies. Multimodal therapy might be a more suitable approach for some individuals, which includes combining behavioral therapy with pharmacotherapy such as neuroleptic-antipsychotic agents (haloperidol, pimozide) or a2-adrenergic drugs (clonidine, guanfacine). Because Tourette’s is a “tic” disorder, medications should be used cautiously due to the increased risk of tardive dyskinesia (TD), a medication induced disorder in which tics worsen or may become permanent. Botulinum toxin (used mostly for complex motor tics), or in the most severe cases, deep-brain stimulation, are also available treatment