Tourette syndrome (TS) in children has been characterized as an involuntary condition whereby an individual performs twitches and tics and, at the same time, makes vocal sounds. Often, such symptoms begin in early childhood, and as childhood progresses, the signs of the disorder vary, with some being missed or misunderstood entirely. Since this disorder may have long-term effects on the growth and social abilities of a child, all the stakeholders – parents and other caregivers – need to be educated on the significant indicators of Tourette Syndrome, its causes, and, indeed, its treatment.
Tourette syndrome is a common ailment among children, but it does not often get the attention and regard it deserves. Pediatric neurologist Dr. RK Jain, also the Managing Director of the Child Neurology Centre, is the best child neurologist in delhi, best known for his distinguishing skills in diagnosing and treating children with neuro-related disorders such as Tourette syndrome. In this blog, I will discuss the symptoms, causes, and treatment of TS, including insights provided by Dr. RK Jain and his associates who work at the Child Neurology Centre, which is regarded as one of the finest children’s hospitals specializing in neurology in India.
General Characteristics of Tourette Syndrome
Tourette Syndrome, or TS, is a neuropsychiatric disorder that is made up of involuntary movements (motor tics) or sounds (vocal tics). These tics usually develop during early childhood, that is, between the ages of 5 to 10 years. Tourette syndrome has not been entirely defined in its cause but is thought to stem from a genetic predisposition and environmental triggering factors.
Tics in Tourette syndrome are said to vary in severity and complexity. They may be in the form of throat clearing, eye blinking, shoulder shrugging, or head jerking, among others. While more of these children may develop motor tics, a significant number may also develop both motor and vocal tics during puberty. Attention is easily lost or diverted in some of the cases. Even younger tics bear a sub-dimensional structure, and Bion’s chaos begins to emerge and attempts to intervene from late adolescence, whereby the disorder manifests into adulthood.
TS Symptoms Pediatrically
A person diagnosed with Tourette syndrome will show signs of tics or have a history. These tics are of 2 types:
1. Motor Tics
Motor tics are concerning movements, and they can include:
- Eye blinking
- Head jerking
- Facial grimacing
- Shoulder shrugging
- Arm or leg movements
- Body rocking or some tapping.
2. Vocal Tics
The involuntary uttering of sounds or words, which include:
- Grunting
- Throat Clearing
- Not a nasal decongestant but a sniff one
- Coughing
- Copying other person’s words, i.e., echolalia.
- Referring to words out of context like awful words (coprolalia) – This is rare but can be pretty disturbing for the little kids and people around them as well.
Frequency and severity are variables when practicing for TS. Some children have very bad tics that can annoy them, while others children only have very occasional mild ones. Tics also change over the year, and when a child is anxious or stressed, the severity changes for the worse. They can use suppression to decrease the symptoms for a little while, which leads to the person getting anxious.
What Causes Tourette Syndrome in Children?
Tourette Syndrome has no known cause, and its mechanism of development is still under active research. However, some factors can lead to the development of this syndrome, and they are as follows;
1. Genetics
Studies show that it is plausible that people suffering from Tourette Syndrome inherited it from their ancestors in their bloodline. For instance, children whose families have a complication of seizure apraxia/syndrome are much more prone than children originating from families who do not have the complication. Moderate or total disability due to TS is believed to be associated with particular genes that impact the regulation of dopamine, an important neurotransmitter associated with movement. The participating studies could not pinpoint a gene as the causative agent of TS.
2. Neurological Factors
It is believed that there are some linkages between Tourette Syndrome and abnormalities existent in the structures of the brain that coordinate and control motions. For example, the motor circuit that contains the basal ganglia and the frontal lobe, which is critical for voluntary motion control, may also contain dysfunction and result in a TS sufferer having uncontrollable tics.
3. Environmental Factors
Environmental factors may also play a role in the development or aggravation of tics in a person, even when genetics are essential, as above-mentioned. For instance, some children find that infections, stress, or trauma trigger or make their tics even worse. Several notable reports of streptococcal infections in children exhibit one of the conditions called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). This would lead to the sudden emergence of tics or other related neuropsychological symptoms.
4. Imbalance of Neurotransmitters
Nourishing Deficiencies of essential neurotransmitters such as dopamine and serotonin might lead to the manifestation of Tourette Syndrome. These substances assist in controlling emotional feelings and activities as well as movement, and any control loss could lead to the involuntary actions and sounds that characterize TS.
Management of Tourette Syndrome in Children
Tic disorders like Tourette Syndrome are lifelong, but with the aid of several treatments, the symptoms can be managed, and the child will have a better life. Since every child has its threshold level of tics, treatment procedures can differ significantly from one child to another. In this case, the aim would be to eliminate or lessen the severity of tics, make sure the child is supported through TS-related difficulties, and finally remove any emotional or behavioral issues linked to TS.
1. Behavioral Therapy
Most people around the globe use Behavioral therapy for the treatment of their Tourette Syndrome, the most common being the Comprehensive Behavioral Intervention for Tics (CBIT). This behavioral therapy is where the child is taught techniques that help them control the urge to tic; these can be placing a competing response, aiding in calming down the person, or getting aware of the triggers that lead to that tic. CBIT can be used along with other forms of treatment, and it has been found beneficial for many TS children with the tendency to reduce tics.
2. Medications
In case of very severe tics in children that are making the child suffer in a working environment, then medication can also be prescribed for them. The following medications are commonly used: – Children with Tourette syndrome are given Antipsychotic drugs autoreceptors (like risperidone and ziprasidone) that reduce the expression of severe tics by acting on the dopamine autoreceptors of the brain. – Alpha-2 adrenergic agonists such as clonidine improve attention to surface and focus while controlling the tics. – Apart from that, localized motor tics like eye movement or neck movement can also be treated via Botulinum toxin (Botox) injections.
Keep this in mind, though: one only takes medication for Tourette’s syndrome when the person does a lot of tics and carbonated drinks or even tablets have failed to improve the condition.
3. Psycho-Social Aspects Treatment
As Tourette Syndrome could be a social stigma for a child, self-psychological care becomes imperative. Cognitive Behavioral Therapy (CBT) can assist children in alleviating TS-related stress or depression. Family trauma therapy may also be recommended if the child’s family needs support regarding the tics and how to manage them.
4. Learning Needs and Support
Providing support to students suffering from Tourette Syndrome is critical because the effects of tics can inhibit a child both socially and academically. This should be communicated to the teachers and school attendants, who will provide adjustments such as extra time for tests or decreased stimulation in the learning process. For some children with anti-learning behaviors that stem from TS, special education might also be warranted.
Pediatric Therapist’s Involvement in the Treatment of Tourette Syndrome
Pediatric neurologists skilled at treating movement disorders are central to diagnosing and treating Tourette Syndrome in children. Dr. RK Jain is the Managing Director of the Child Neurology Center, internationally recognized as a top expert in pediatric neurology. With him in charge, the Center for Child Neurology has developed into a significant center for child neurology in India, providing the latest in diagnosis and treatment of children suffering from all forms of neurological conditions, Tourette syndrome included.
According to Dr. RK Jain and colleagues, the treatment of Tourettes syndrome should be multidisciplinary to provide an integrative management that considers the diversity of the aspects of the disorder affecting the child. They effectively team up with psycho-pediatricians, behavioral therapy specialists, and teachers to formulate and implement a comprehensive treatment for TS children.
Conclusion
Tourette syndrome is a complex disorder that makes a child’s life quite challenging. Early diagnosis, awareness of the signs, and appropriate treatment approaches are sufficient to take control of this condition. With the help of experienced neurologists like Dr. RK Jain and the expertise of the Child Neurology Center team, the children affected with Tourette syndrome have all the possibilities to be happy and prosperous. If you think your child might be suffering from Tourette syndrome or would like expert advice in handling the condition, Child Neurology Center has some of the best pediatric neurologists in India dealing with children suffering from neurological disorders. Moreover, it has Dr. RK Jain and his team aim to make life easier for every child with issues of Tourette syndrome as well as other related problems.