The main symptoms of Tourette’s syndrome are motor and sound tics, often accompanied by psychiatric disorders. tics occur intensely and repeatedly, but they can be temporarily controlled by voluntary effort, although this is usually limited to short periods.
In children, the types of tics vary over time: some may disappear to make way for others. In adulthood, tics improve or disappear spontaneously in many cases, although the mechanisms for this improvement remain poorly understood. However, in 23% of cases, symptoms persist or worsen.
It is also important to note that tics, be they motor or sound, can be removed momentarily through intense concentration. In addition, they tend to decrease during activities that require sustained attention. The tics are often preceded by a premonitory sensation, a physical or psychological feeling that causes the patient to perform the tic. These characteristics, together with the variability of tics over time, are essential criteria for the diagnosis of Tourette’s syndrome.
Engine tics
The motor tics manifest themselves in sudden, involuntary and repeated muscle contractions and movements, and are almost permanent. First, they touch the upper body, the face as a grimace, the head and the shoulders/arms. Climbing the eyes, shaking the head, moving the arm or shoulders, each tic remains fairly localized. More complex movements may also represent tics such as jumping, looking back, touching or grabbing an object.
These tics may also be more complex with a tendency to repeat movements observed in others, echopraxia or a propensity to make obscene gestures, copropraxia.
Sound tics
Sound tics are the most well known in the public mind, especially coprolalie, the tendency to make repeated and uncontrolled insults. However, it affects only a very small number of patients but constitutes a social stigma that is very difficult for patients to live with. In the majority of cases, sound tics take the form of simple noises such as sniffing, throat-scraping or touching. More complex sounds, as in the case of coprolalia, may still exist but most often consist of the repetition of syllables or words, palilalia, without connotations of coarse language or the repetition of other people’s words, echolalia.
Factors conducive to the manifestation of tics
Several factors may be involved in the frequency and intensity of tics. Stress and fatigue tend to favour them, while calmness and concentration help to reduce them.
Associated psychiatric symptoms
Gilles de la Tourette syndrome is in the majority of cases associated with psychiatric and behavioural symptoms or pathologies. First, attention deficit disorders, whether or not associated with hyperactivity, are present in a high proportion of patients. Obsessive Compulsive Disorder (OCD) is also encountered and manifests itself in the presence of pervasive obsessions. To relieve the anxiety, the person performs invasive rituals that have a considerable impact on daily life. Patients may also develop concurrent oppositional defiant disorders, anxiety, depressive syndrome or autism spectrum disorder.
At Paris Brain Institute
In a study published in the journal Cortex, Cyril Atkinson-Clément and Yulia Worbe (Sorbonne University/APHP) in the team “Mov’it: movement, investigations, therapeutics. Experimental pathophysiology and Therapeutics" at the Brain Institute, show that, contrary to what we might think, the control of motor impulsivity, the trait that characterizes the ability to inhibit a movement or action already begun, is not correlated with tics in patients with Gilles de la Tourette syndrome.
More info: https://institutducerveau-icm.org/en/actualite/syndrome-gilles-de-tourette-impulsions-motrices-ne-predisent-tics-patients/
