Misconception and Misdiagnosis of Tourette Syndrome
{draw:g} {draw:g} {draw:g} Tourette syndrome, (TS), named after Gilles de la Tourette who discovered the condition, is a disorder that causes motor and vocal tics due to a chemical imbalance in the brain. Neurotransmitters constantly misfire in the brain of a TS sufferer releasing a chemical, known as dopamine, which transmits signals to many parts of the body causing these uncontrollable tics. Lange, Olivier and Meyer (2003) states, “This neuropsychiatric disorder is, in all likelihood, genetically determined and associated with neurotransmitter (“chemical”) imbalances in the brain. Although there is no known cure for TS, medications are available that help control the condition. Society often misunderstands those who suffer from TS, because the condition is commonly misdiagnosed and misunderstood. There are many misconceptions about TS and much of society is poorly educated and misinformed about the condition. Physicians do not refer to TS as a disease, but more commonly as a “condition”, even though people lend to view those who suffer from TS as having some debilitating disease.
Although this is not an accurate conception of syndrome, some patients with severe case may suffer some type of debilitation. One of the most common misconceptions that society has regarding TS patients is that they curse uncontrollably in public. The media contributes to this by depicting characters with the syndrome in movies displaying this type of behavior. This is entirely inaccurate and represents only a small percentage of TS patients with more severe cases. Society is also guilty of misrepresenting and misunderstanding people with TS, often using hurtful quips or acting out in jest towards people who have this condition.
This is not only psychologically damaging to TS patients but can temporarily cause tics to become more severe due to stress and discomfort associated with ridicule. TS is no joking matter and is a serious condition that affects the daily lives of many people. There are public awareness groups that have information needed to provide better understanding of TS as well as how to live with the condition once diagnosed. The most notable is the Tourette syndrome association (TSA) founded by group of medical professionals, laypeople and TS patients.
This organization educates people about the condition and provides assistance, information and encouragement to those who have it. TSA has been instrumental in bridging the gap between the medical profession and the public. Tourette syndrome generally develops in early childhood between ages of four and eight. Mayo clinic staff (2004) wrote the following: “The first symptom of Tourette syndrome is usually a facial tic, such as eye blinking. As many as 1 in 200 children develop tics that last only a few weeks or months and then stop. Tourette syndrome, however, involves multiple motor and vocal tics that have lasted longer than a year. Children with TS, like a percentage of children who develop tics that eventually disappears, often experience a wax and wane of tics over a long period, making it difficult condition to diagnose. The symptoms of TS include motor and vocal tics as well as behavior symptoms such as obsessive-compulsive disorder (OCD) and attention-deficit hyper-activity disorder (ADHAD). Motor tics may include heard jerking, eye blinking or twitching, shoulder shrugging as well as unusual torso or limber movements. Vocal tics include throat clearing, coughing, humming and uncontrollable cursing.
OCD and ADHAD are psychological co-morbid behaviors that are associated with many patients with TS. Although there is no guaranteed predisposition to these co-morbid behaviors for every TS patient, it does play an active role in most cases. Budman and Feirman (2001) stated, “Disturbances of affective regulation, including mood disorders, OCD, obsessive-compulsive symptomatology, non-OCD anxiety disorders, ADHAD, personality disorders, and self-injurious behaviors, have been reported to occur more frequently among patients with Tourette’s syndrome who are seen in clinical settings. Again, this is not a medical adherence to a guaranteed predisposition to these behaviors. It is; however, a good indication that they are likely occurring more often than not in TS patients. This supports many doctors and physicians belief that TS is a genetically inherited condition. Effective diagnosis of TS is a long-term process. In order for doctors to make a positive diagnosis, monitoring of patients for a period of several months is necessary to determine critical question is the degree to which tics are interfering with the child’s emotional, social, familial, and school experiences.
To determine this, it is useful to monitor symptoms over a few months in order to assess their severity and fluctuation, impact on the family, and the child’s and A medical professional skilled in the observation and treatment of TS is required to make accurate diagnosis. Just as Gilles de la Tourette observed long ago, most doctors and leading experts still believe there are genetic linkages associated with TS. Leckman (1997) states, “Gilles de la Tourette’s original reports hypothesized an etiologic role for hereditary factors.
Subsequent twin and family studies confirm that genetic factors play an important role in the transmission and expression of TS. ” practitioners believe that natural and behavioral methods can assist in the control and tolerance of TS, although there is no agreement about treatment in this manner. The most effective treatment, although not without substantial risks and side effects, is that of pharmacotherapy. Medications can reduce symptoms of TS significantly but ultimately may cause side effects, which are also difficult to live with.
Alpha-adrenergic medications such as Clonidine and Atypical and typical neuroleptics such as haloperidol and pimozide, though studied and administered the most can have more severe side effects. Neuroleptics cause side effects that include weight gain, sedation, and EKG abnormalities. Alternative treatments such as relaxation and discipline techniques can be effective in reducing the onset and severity of tics but only provide temporary relief of symptoms. As TS patients learn how to cope with their condition and adapt to the challenges that it can cause in everyday life, sustaining a normal, fulfilled life as possible.
Social ramifications can have devastating effects on TS patients who are incapable of finding self-worth due to social anxiety and/or personality behavior disorders associated with the condition. These challenges can be more difficult to overcome than the condition itself. Due to misunderstanding and lack of patience between parents and children, problems in home can have a profound effect on a child’s emotional and psychological state. The key for a family is to seek professional guidance and counseling to learn how to deal with and accept the challenges that TS may cause at home.
The long-term, lifelong challenges that TS poses to patients are complex. First, acceptance of the condition is imperative. Secondly, and even more important, professional guidance is encouraged in order to help TS patients deal with and adapt to the changes and challenges that he or she will face in life. . Third, as TS sufferers deal with social and personal conflicts, each must find balance in his or her own life through combination of emotional, physical, and medical treatments and methods that are necessary to gain control over the condition.
Lastly, it is extremely important for TS patients to find positive experiences and factors in his or her situation. Most people with condition demonstrate certain gifts or abilities such as increased determination and drive, inner and physical strengths, creativity and intelligence. the gifts that TS patients demonstrate. Swain and Leckman (2005) state, “Children with TS are often observed to be particularly attuned to the concerns and well being of others, possibly because of their own experience of illness. ” These positive traits can help offset the negativities often experienced by TS sufferers.
As with anything, the more positive attitude a person adapts in life, the more likely he or she is to succeed and flourish. TS is a condition not considered debilitating or handicapping to anyone, although more severe cases reported have such effects. For society to understand and accept people who suffer from TS, more information needs to be readily available via the internet, medical journals and media coverage in order to educate the general population on this fascinating condition of the human mind and body.
Society often misunderstands those who suffer from TS, because the condition is commonly misdiagnosed and misunderstood. Tourette syndrome is not contagious; therefore, no one has a reason to fear or reject those who suffer from the condition. References Mayo Clinic Staff (2004, March). Tourette syndrome. hhtp://www. mayoclinic. com Swain, J. J. , & Leckman, J. F. , (2005) Tourette syndrome and tic disorders: Overview and Practical Guide to Diagnosis and Treatment. _ Psychiatry_ Leckman. J. F. , (1997, April).
What Genes Confer Vulnerability to Gilles de la Tourette’s syndrome? Psychiatric Annals. Olivier, M. A. J. , Meyer, L. W. , & De Lange, N. (2003). Tourette’s syndrome: isn’t that the foul mouth disease? Early Child Development and Care Prestia, K. (2003, November). Tourette’s syndrome: Characteristics and Interventions. Intervention in School and Clinic. Budman, C. L. , & Feirman, L. (2001, September). The relationship of Tourette’s syndrome with its psychiatric co-morbidities: Is there an overlap? Psychiatric Annals.
