Tourette’s syndrome

Tourette’s syndrome is an inherited disease that affects men more often than women. It also affects a specific region of the brain, the basal ganglia. Ultimately, many different causes of Tourette’s syndrome are currently being discussed.

However, no theory has been proven to the extent that one can speak of a definite cause. The patients suffer from motor tics (winking eyes, mouth twitching, tongue clicking, shoulder twitching). Tics are uncontrollable muscle movements.

Vocal tics are also possible (noises, coughing, grunting, even whole words). Obsessive-compulsive disorders are also among the symptoms. The diagnosis is made by interviewing the patient, neurological examinations and the EEG.

As therapy, play and talk therapy are possible. The obsessive-compulsive symptoms can be treated with medication. Also the tics are tried to be controlled by medication.

What do accompanying symptoms look like?

If an extrapyramidal syndrome with an excess of movement manifests itself, involuntary arm movements occur. The facial muscles are also often moved involuntarily, for example in the form of chewing movements. If an extrapyramidal syndrome manifests itself with a lack of movement, tremor may occur, freezing when starting to move or when reaching for an object (i.e. the patient wants to perform the movement but the foot or hand simply does not start moving).

The facial expressions can also become poorer overall, so that the person concerned usually shows only a face without expression.The severity of the symptoms may indicate certain diseases. In general, those affected also fall more frequently. Since many of the causative illnesses belong to the neurodegenerative group, accompanying dementia often occurs.

The personality of the person affected can also change. For example, seemingly unfounded aggressions can occur. If the affected person notices these changes, depression is not a rare accompanying disease.

How do you make the diagnosis?

The diagnosis is made primarily through a detailed medical consultation (technical term: anamnesis) and a detailed physical examination. It is examined exactly which kind of movement poverty or movement surplus is present and how it expresses itself. In some cases, a clear diagnosis can be made.

However, since different clinical pictures merge into one another, until a definitive diagnosis is made, the only thing that is often discussed is the presence of an extrapyramidal syndrome. Certain imaging procedures (e.g. certain MRI examinations) and certain blood values in some cases can confirm the diagnosis. Often other diagnostic procedures are also connected in order to exclude other diseases.

Sometimes genetic tests, a withdrawal of spinal fluid (technical term: cerebrospinal fluid) or the response to certain drugs are part of the diagnostic process. A general statement about a prognosis is not possible. It depends entirely on the specific clinical picture and the various treatment options as well as on the patient’s medical history and family history.