Tic triggers. 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. Hearing another person sniff or clear the throat may trigger similar sounds. Tics do not go away during light sleep but are often significantly diminished; they go away completely in deep sleep. Although the symptoms of TS are unwanted and unintentional called involuntary , some people can suppress or otherwise manage their tics to minimize their impact on functioning.
However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed against their will. Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.
Disorders Associated with TS. Many individuals with TS experience additional co-occurring neurobehavioral problems how the brain affects emotion, behavior, and learning that often cause more impairment than the tics themselves. Although most individuals with TS experience a significant decline in motor and vocal tics in late adolescence and early adulthood, the associated neurobehavioral conditions may continue into adulthood.
The most common co-occurring conditions include:. Educational Settings. Although students with TS often function well in the regular classroom, ADHD, learning disabilities, obsessive-compulsive symptoms, and frequent tics can greatly interfere with academic performance or social adjustment.
After a comprehensive assessment, students should be placed in an educational setting that meets their individual needs. Students may require tutoring, smaller or special classes, private study areas, exams outside the regular classroom, other individual performance accommodations, and in some cases special schools. To diagnose TS, a doctor looks for the following:. Common tics are often diagnosed by knowledgeable clinicians.
However, atypical symptoms different from classical symptoms or atypical presentations for example, symptoms that begin in adulthood may require specific specialty expertise for diagnosis. There are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging MRI or computerized tomography CT , electroencephalogram EEG studies, or certain blood tests may be used to rule out other conditions that might be confused with TS.
It may take some time to receive a formal diagnosis of TS. Families and physicians unfamiliar with the disorder might think mild and even moderate tic symptoms may be negligible or unimportant, a part of a developmental phase, or the result of another condition. For example, some parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies.
Because tic symptoms often are mild and do not cause impairment, some people with TS require no treatment. Having a tic is hard to control. The motor and vocal tics of Tourette are involuntary, meaning that people do not do the tic on purpose.
While the exact cause of tics is still not known, many people compare the feeling of having a tic to having an itch or having to sneeze. You may try to stop the feeling, but eventually you will probably scratch or sneeze and you will feel a little better until the urge comes back. When people try to hold back their tics, it can cause stress and the tic may become worse. It is true that some people with Tourette have difficulties throughout their lives. It is also true that many people with Tourette are very successful.
They are often high achievers and find that their tics can become less severe or go away when they are concentrating on a task at hand. Many people also have fewer tics as they grow up. There are people with Tourette who are successful in all walks of life and they work in many areas, including the arts, medicine, sports, and other professions. Or, the type of tic may change.
Some people may be able to suppress their tics for a short time. But tension builds, and it eventually has to be released as a tic. And if a person is concentrating on controlling the tic, it may be hard to focus on anything else. This can make it hard for teens with Tourette syndrome to have a conversation or pay attention in class. Many teens with Tourette syndrome also have other conditions like attention deficit hyperactivity disorder ADHD , obsessive-compulsive disorder OCD , learning disabilities, and anxiety.
Tics should be checked out by a doctor. Some family doctors may refer a person with Tourette symptoms to neurologist a doctor who specializes in problems with the nervous system. The neurologist may ask the person to keep track of the kinds of tics involved and how often they happen. For a diagnosis of TS, a person must have several different types of tics — specifically, multiple motor tics and at least one vocal tic — for at least a year.
They may happen every day or from time to time throughout the year. There isn't a specific test for Tourette syndrome. Instead, the doctor looks at the family history, the medical history, and the person's symptoms to make a diagnosis. Sometimes, imaging tests like magnetic resonance imaging tests MRIs , computerized tomography CT scans, electroencephalograms EEGs , or blood tests can rule out other conditions that might cause symptoms similar to TS.
Just as Tourette syndrome is different for every person, treatment can be different, too. While there isn't a cure for Tourette syndrome, most tics don't get in the way of day-to-day life. For example, a person might keep blinking over and over.
Or, a person might make a grunting sound unwillingly. Having tics is a little bit like having hiccups. Even though you might not want to hiccup, your body does it anyway.
Eventually the person has to do the tic. Motor tics are movements of the body. Examples of motor tics include blinking, shrugging the shoulders, or jerking an arm.
Vocal tics are sounds that a person makes with his or her voice. Examples of vocal tics include humming, clearing the throat, or yelling out a word or phrase. Simple tics involve just a few parts of the body. Examples of simple tics include squinting the eyes or sniffing.
Complex tics usually involve several different parts of the body and can have a pattern. An example of a complex tic is bobbing the head while jerking an arm, and then jumping up. The main symptoms of TS are tics.
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