What're the symptoms of Tourette's syndrome?
Tourette's syndrome often begins with muscle tics. Many people who do not have this disorder have simple tics, such as repetitive eye blinks, which are nervous habits and may disappear with time. Simple tics are sudden, brief movements involving a single group of muscles or a few groups, which may be repeated several times. Complex tics consist of a repeated pattern of movements that can involve several muscle groups and usually occur in the same order. For instance, a boy with Tourette syndrome may repeatedly move his head from side to side, blink his eyes, open his mouth, and stretch his neck. Vocal tics may be sounds or noises that lack all meaning, or repeated words and phrases that can be
understood. Tics tend to get worse and better in cycles, and patients can develop new tics as they grow older. The symptoms of Tourette syndrome may get much better for weeks or months at a time, only to worsen later.
A number of examples will show why Tourette syndrome can be such a strange and dramatic disorder. Simple motor tics (blinking the eyes, pouting the lips, shaking or jerking the head, shrugging the shoulders, and grimacing or "making faces"). Any part of the body may be tensed up or rapidly jerked, or a patient may suddenly kick out. Rapid finger movements are common, as are snapping the jaws and clicking the teeth. Complex motor tics (jumping, touching part of the body or certain objects, smelling things over and over, stamping the feet, and twirling about). Some Tourette syndrome patients throw objects, others arrange things in a certain way. Biting, head-banging, writhing (snake-like) movements, rolling the eyes up or from side to side, and sticking out the tongue all may be seen. A child may write the same letter or word over and over, or may tear apart papers and books. Though they do not mean to, Tourette syndrome patients may make obscene gestures like "giving the finger," or they may imitate any movements or gestures made by others. Simple vocal tics (clearing the throat, coughing, snorting, barking, grunting, yelping, clicking the tongue). Patients may screech or make whistling, hissing, or sucking sounds. They may repeat sounds such as "uh, uh," or "eee." Complex vocal tics and patterns. Older children with Tourette syndrome may repeat a phrase such as "Oh boy," "all right," or "what's that?" Or they may repeat everything they, or others, say a certain number of times. Some patients speak very rapidly or loudly, or in a strange tone or accent. Coprolalia (saying "dirty words" or phrases that are sexual or aggressive) is probably the best known feature of Tourette syndrome, but fewer than one-third of all patients actually do this.
Behavioral abnormalities that may be associated with Tourette syndrome include attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviors, including conduct disorder and oppositional defiant disorder, with aggressive, destructive, antisocial, or negativistic behavior. Academic disorders, learning disorders, and sleep abnormalities (such as sleepwalking and nightmares) are also seen.