Tourette syndrome is a hereditary psychiatric disorder due to neurochemical dysregulation of the brain, characterized by vocal (voice) and motor (muscle) tics that usually begin at the age of 5-6. It was first described in 1825 and was named after the French doctor Gilles de La Tourette in 1885. Tics increase with adolescence. Although in most cases the number and severity of tics decrease towards the end of adolescence, it is a chronic disease that usually lasts a lifetime. In order for a person to be considered to have Tourette syndrome, they must have at least two motor and one vocal tic and these tics must have started before the age of 18. Unfortunately, most people in society do not know that this is a hereditary disorder. While it can reduce the quality of life physically, ticism can also cause social difficulties. When people with tics are asked questions that shouldn't be asked, such as "Why do you have a tic?" "You shouldn't do those tics anymore," "You make too much noise because of your tics," "How can I trust the psychology of someone with a tic?" they experience difficulties among their peers. People with tics are disturbed by such questions and the other party may not realize how much discomfort they cause.
What causes Tourette syndrome? What are the clinical symptoms and types?
Tourette syndrome is a type of disease that usually begins in childhood. It is thought to be caused by a neurochemical disorder in the part of the brain called the basal ganglia, where motor movements are regulated. Tics are sudden, intermittent, repetitive, non-rhythmic involuntary movements that occur as a result of involuntary contractions of motor or vocal muscles. It is very difficult to resist these movements. It can significantly impair quality of life and communication.
Motor tics (muscle tics): head shaking, eyebrow-eye movement, eye blinking, neck turning, eye rolling, teeth grinding, shoulder movement. It may occur in the form of sticking out the tongue, grimacing, involuntary back movements and many other involuntary muscle movements.
Vocal tics (voice tics): Throat cleaning sound, repeating certain sounds, reading and repeating what is written on television or somewhere (Echolalia: repeating the other person's words aloud or silently to oneself), o It can vary from coughing to making complex sounds, from various speech disorders to coprolalia (swearing).
Psychological Factors: Studies have shown that tics can occur after various stressful situations. There is an increase in the number and severity of tics in cases of expectation from an important situation, preparation for an exam, fatigue, anxiety, excitement, anger and panic.) Additionally, punishments given by the family and the environment for tics may cause an increase in tics, or in some motivation-requiring activities, tics may disappear temporarily; For example, doing sports, playing an instrument, singing. According to US data, nearly 75% of individuals with Tourette syndrome are interested in any sport or art. The incidence rate in the general population is 4-5/10,000. It is generally seen more in boys, the male/female ratio is 2/1.
Genetic factors: Genetic, environmental factors, neurobiological and neurotransmitters interact with each other. It is thought that they interact to create the disorder. Genetic transmission is especially high in Tourette syndrome.
Tourette syndrome and related diseases
Tourette syndrome is related to psychiatric disorders such as obsessive compulsive disorder, attention deficit and hyperactivity disorder. and many people with Tourette syndrome may have these diagnoses simultaneously.
Treatment
Treatment of tic disorders includes supportive interventions and medication. It can happen in two ways. In addition to the treatment, a psychoeducational plan should be made that includes the psychological and social situation. Although these cases respond to drug treatment, it is more difficult for the symptoms to regress in adulthood if they are not treated in childhood. It should be explained to the environment and the family that this is a disease and that voluntary control is not possible. It should also be said that warnings and punishments will cause an increase in tics. Establishing a connection with school is very important for children's school adaptation and success, especially in children with vocal tics. Medication may not always be necessary. However, when the quality of life deteriorates, school, home, work and social Drug treatment is appropriate during periods when life is affected. Drug treatment should be carefully selected and continued under control by a psychiatrist.
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