Tourette Syndrome, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Tourette syndrome (TS), sometimes called Tourette disorder (TD), is a neurological medical disorder featured by multiple repeated tics.
Tics are sudden, purposeless, and involuntary vocal sounds or muscular jerks.
Tourette syndrome is a disorder that causes a person to make repeated, quick movements or sounds that they cannot control.
Symptoms of TS normally start between the ages of 5 and 10 years, and normally start with mild, simple tics involving the face, head, or arms.
With time, tics may occur more often and add to differences.
They may also affect more body parts, such as the trunk or legs, and often become more disturbing to activities of daily living (ADLs).
Causes
Genetics
Tourette syndrome tends to be passed down through families.
The syndrome may be linked to problems in certain areas of the brain.
It may be related with chemical substances (dopamine, serotonin, and norepinephrine) that assist nerve cells signal one another.
Tourette syndrome is an autosomal dominant disorder.
Autosomal indicates that both males and females are affected and dominant indicates that one copy of the gene is essential to have the disorder.
This indicates that a parent with TS or a parent who has the gene for TS has a 50/50 chance, with each pregnancy, to pass the gene on.
Childhood infection
Another theory is TS formation may be linked to a childhood infection by streptococcal bacteria (bacteria that normally produce a sore throat).
Trying to fight off the infection, the immune system forms antibodies (proteins).
The antibodies may react with brain tissue, involving the brain's functioning.
Following a throat infection, some children have developed the symptoms of TS, and the symptoms of obsessive compulsive disorder (OCD).
Symptoms of Tourette syndrome is often first observed during childhood, between ages 7 and 10.
The most frequent first symptom is a tic of the face.
There are many types of tics.
Some affect body movement (motor tics) and others result in a sound (vocal or phonic tics).
Tics can be:
1. Vocal (sounds) – such as grunting, coughing or shouting out words
2. Physical (movements) – such as jerking of the head or jumping up and down
They can also be:
1. Simple – making a small movement or uttering a single sound
2. Complex – making a series of physical movements or speaking a long phrase
Most people diagnosed with TS have a combination of physical and vocal tics, which can be both simple and complex.
The tics do not normally pose a serious threat to a person's overall health condition, even though physical tics, such as jerking of the head, can often be painful.
To be diagnosed with Tourette syndrome, a person must:
1. Have had many motor tics and 1 or more vocal tics, even though these tics may not have happened at the same time.
2. Have tics that happen many times a day, nearly every day or on and off, for a period of more than 1 year.
3. During this duration, there must not have been a tic-free period of more than 3 months in a row.
4. Have begun the tics before age 18.
5. Have no other brain disorder that could be a likely reason of the symptoms
People who have mild symptoms are not medically treated.
The main treatments for TS are:
Behavioral therapy is a widely used non-medical treatment for tics.
1. Habit reversal therapy
2. Exposure with response prevention (ERP)
3. Medicines
Dopamine antagonists
Muscle relaxants
Alpha2-adrenergic agonists
4. Surgery and deep brain stimulation (DBS) are last resort treatments for TS
DBS requires permanent implantation of electrodes
By stimulating certain areas of the brain the symptoms of TS can often be regulated

TABLE OF CONTENT
Introduction
Chapter 1 Tourette Syndrome
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6

• Language: English
• Publisher: Kenneth Kee
• Release date: Mar 25, 2017
• ISBN: 9781370183722

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Tourette Syndrome,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2017 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Tourette Syndrome, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Tourette Syndrome)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Tourette syndrome

I was watching a movie on TV the other day about Tourette Syndrome The Road Within.

It was interesting because the main character had 2 companions who were anorexic and obsessive compulsive, both psychological disorders which I had wrote about before in my simple guides.

What is Tourette syndrome (TS)?

Tourette syndrome (TS), sometimes called Tourette disorder (TD), is a neurological medical disorder featured by multiple repeated tics.

Tics are sudden, purposeless, and involuntary vocal sounds or muscular jerks.

Tourette syndrome is a disorder that causes a person to make repeated, quick movements or sounds that they cannot control.

Symptoms of TS normally start between the ages of 5 and 10 years, and normally start with mild, simple tics involving the face, head, or arms.

With time, tics may occur more often and add to differences.

They may also affect more body parts, such as the trunk or legs, and often become more disturbing to activities of daily living (ADLs).

What causes Tourette syndrome?

Causes

Genetics

Tourette syndrome tends to be passed down through families.

The syndrome may be linked to problems in certain areas of the brain.

It may be related with chemical substances (dopamine, serotonin, and norepinephrine) that assist nerve cells signal one another.

Tourette syndrome is an autosomal dominant disorder.

Autosomal indicates that both males and females are affected and dominant indicates that one copy of the gene is essential to have the disorder.

This indicates that a parent with TS or a parent who has the gene for TS has a 50/50 chance, with each pregnancy, to pass the gene on.

Tourette syndrome is linked with a non-genetic cause in 10% to 15% of children.

Complications of pregnancy, low birth weight, head trauma, carbon monoxide poisoning, and encephalitis are thought to be linked with the start of non-genetic TS.

Dominant disorders indicate something known as incomplete penetrance.

This suggests that not everyone with the gene will have symptoms of Tourette syndrome.

That is, if a parent passes the gene on to a child, the child may not have any symptoms of the disorder.

If a daughter takes over the gene, there is a 70% chance that she will have at least one of the signs of TS.

On the other hand, if a son is given the gene, there is a 99% chance that he will have at least one of the signs of TS.

Eventually, dominant disorders can also reveal something known as variable expressivity.

This suggests that there are variations in the expression of the TS gene in different people.

One person with TS can have obsessive-compulsive disorder while another person has a chronic tic disorder, while another has full-blown TS.

Also, there are variations in expressivity between males and females.

Males tend to be more likely to have full-blown TS or chronic tics, while females tend to be more likely to have obsessive-compulsive disorder (OCD).

This is an anxiety disorder in which a person has an irrational thought, fear, or worry (obsession) that he or she tries to go through a ritualized activity (compulsion) to decrease the anxiety.

It also often occurs alongside other conditions, such as:

1. Attention deficit hyperactivity disorder (ADHD)

2. Obsessive compulsive disorder (OCD)

3. Writer’s cramp

4. Impulse control disorder

TS can sometimes be triggered by taking illegal drugs, such as cocaine or amphetamines, and are sometimes caused by more severe health disorders such as cerebral palsy or Huntington's disease.

Childhood infection

Another theory is TS formation may