This is a disorder of a combination of both vocal and motor tics. It should be considered a part of a behavioral disorder spectrum that consists of tics, obsessive-compulsive behavior, and attention deficit hyperactivity disorder. In order to qualify for the diagnosis of Tourette’s disorder the tics must be present for over 1 year and never resolve for a period longer than 2 months. The natural course of the disorder is fluctuating. The fluctuations of the symptoms may or may not be related to stress factors.
The origin of the disorder is genetic, believed to be transmitted in an autosominal dominant manner, but other genetic factors may play a role, including gene amplification (worsening with consecutive generations) and genetic imprinting (having a different presentation in inherited from the mother’s or father’s chromosomes). The usual presentation of Tourette’s disorder is with some increasing hyperactivity and irritability. At this time some kids may be diagnosed with AD/HD and started on stimulant medication, to be later discontinued as tics develop. The tics usually evolve initially involving motor tics in the face area, such as eye blinking, facial grimacing, hair fixing, mouth opening, nasal flaring, and neck jerking. The tics then evolve to the shoulders and extremities. Usually the vocal tics develop later and frequently consist of throat clearing. Other vocal tics may consist of humming sounds, grunting, high-pitched noises, yelling, and actual words, usually curses.
The vocal and motor tics may occur concomitantly but don’t have to in order to qualify for the diagnosis of Tourette’s.
Obsessive-compulsive behavior, anxiety, and depression may be associated with the disorder and usually develop later into the course of the disorder.
The full-blown condition may be extremely disruptive and living with it may be difficult. Treatment may be helpful to various degrees.