I RECEIVED a request to talk about a Neurological disorder that quite a few people in Guyana have been diagnosed with. If you or a friend /family member are one of the inflicted, I hope this piece helps you to better understand the illness as well as how to deal with it.

Tourette syndrome (TS) is characterised by repetitive and involuntary movements or communication/words – which are called tics.
We sometimes see comical versions in movies, where someone would shout out something funny or random at inappropriate times. Sadly, however, it doesn’t depict the daily struggles of the individual.

The onset of Tourette’s typically happens in childhood – between the ages of three to 10 but the tics are most severe between the ages of eight to 12. It is four times more common in males than females. TS is not a degenerative disorder which means that it doesn’t get worse over time or has much progressive physical or mental impairment; it does not affect intelligence. This means that an individual with TS has a normal life expectancy.

The symptoms of TS range from mild to severe – whether physical or verbal. They are typically sudden, short and repetitive, begin in the head and neck area and then further progress to other extremities. Motor tics (physical movements) usually show before vocal (speech) ones.

The involuntary physical movements may involve excessive blinking, sniffing, jaw movements and head or shoulder jerking. The more obvious ones may be hopping or jumping or arm/leg jerking.

The verbal symptoms can be grunting, throat clearing, coughing, barking, shouting or even repeating full sentences that others around them say. The comical kind we see in the media is called Coprolalia- where the individual may shout out inappropriate words but this only happens in a small percentage of people with Tourette’s syndrome.

Both physical and verbal tics are random, mostly unpredictable and based on the individual- differ in frequency and severity. Some individuals are aware that a tic is coming on, much like when we know we are about to sneeze. Just as we cannot hold it in, it is a need and compulsion for them to practice the tic. People diagnosed with TS describe a high tension or pressure if they are unable to carry out their tic.

It is important to be aware and on the lookout for these tics. I remember the first case of TS I saw in Guyana. The child’s mother was complaining that her son was being rude and disobedient; that he never did what she asked of him. She claimed she would spank the child and his response would mostly be to suck his teeth. She simply wanted help to deal with his insubordination. Unfortunately, little did she know that he had TS and the sucking of the teeth was his tic. Since tics often worsen during times of stress, every time she spanked him, he showed signs of TS. I’m positive that her story is not an isolated one and guardians should do their best to observe any abnormal behaviour.

If the symptoms are severe and they are restricted from carrying out their tic, it can result in self-harm such as hitting themselves in the face.
There are a few factors which can determine how severe the diagnosed person will be; these include problems during birth, low birth weight or whether the mother smoked cigarettes during the pregnancy.

People with Tourette’s may have issues with sleeping, socialising, learning, motivation and self-esteem. Due to this, TS can co-occur with a variety of mental illnesses such as depression, anxiety, panic attacks, attention deficit disorder, Obsessive-Compulsive Disorder and sleep disorders.

The exact cause of Tourette’s is unknown but research has determined that it is a complex mix of biological (abnormalities in the brain), genetic and environmental factors.
There are no tests or scans to identify Tourette’s; a diagnosis is made if the person has experienced two or more motor tics and at least one vocal tic in the past year.
Much like mental illnesses, TS is a chronic condition which means it cannot be cured. Typically, as the adolescent moves into adulthood, the tics disappear on their own.

If this is not the case, it can still be managed and properly treated. Tourette’s generally does not require any medication as treatment; although some may be prescribed if certain symptoms are affecting daily life. Talk and cognitive behavioural therapy are recommended to reduce the risk of psychiatric disorders that may form and have an overall better quality of life. There are also dietary restrictions to speak to your doctor about, as research shows this can affect the frequency and severity of tics. For example sugar, caffeine and gluten may worsen tics.

Relaxation techniques such as breathing exercises and yoga have proven effective in reducing symptoms of TS.
Education on the illness, for both, the inflicted as well as their family and friends, is a very important part of any treatment plan. It is important for you as well as those around you to understand the illness as well as the best way to treat and manage it. This ensures a tolerant, accommodating and compassionate setting for the inflicted individual.

Please keep sending any topics you’d like to talk about to caitlinvieira@gmail.com Or come in to see me at:

Georgetown Public Hospital: Psychiatric Department:
Monday- Friday – 08:00hrs-12:00hrs
Suicide Prevention Helpline numbers: 223-0001, 223-0009, 623-4444, 600-7896
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