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TOURETTE SYNDROME IN CHILDREN

(COMBINED VOCAL AND MULTIPLE MOTOR TIC DISORDER)
Tourette Syndrome in Children

WHAT YOU NEED TO KNOW:

What is Tourette syndrome (TS)? TS is a disorder that causes your child to have tics. A tic is when your child makes sudden, fast movements or sounds that he cannot control. TS begins before 18 years of age, usually between 7 and 12 years.

What increases my child's risk for TS? The exact cause is not known, but it may be linked to genetic changes that cause problems with chemicals in the brain. These chemicals affect the nerves that help control your child's movements, behavior, emotions, and thoughts. Your child is more likely to have TS if a close family member has TS. It is more common in boys. Ask your child's healthcare provider for more information about family history and other risk factors for TS.

What kinds of tics may my child have? Your child will have at least 2 kinds of motor tics and at least 1 kind of vocal tic. The motor and vocal tics might happen at the same time, but they might happen separately. Your child will need to have the tics for at least 1 year before his healthcare provider will diagnose TS. Your child may have any of the following several times every day:

  • Motor tics can be simple or complex. Simple motor tics are short, quick, uncontrolled movements of one body area. Complex motor tics occur when your child has many simple motor tics at one time. Common examples include eye blinking, teeth grinding, or foot tapping. He may also bite or punch himself, shrug his shoulders, or twitch his nose.

  • Vocal tics can be simple or complex. Simple vocal tics are when your child makes uncontrolled noises and sounds. Complex vocal tics are when your child speaks words or phrases without having control over what he is saying. Common examples include barking, throat clearing, or shouting. He may also make a sucking noise, curse, or say inappropriate things.

What should I know about tics?

  • Your child's tics may be worse when he is alone, stressed, tired, excited, or worried.

  • Your child may have warning signs before his tics begin, such as feeling cold, warm, itchy, tingly, or heavy. When the tic occurs, these feelings go away.

  • Your child may have fewer tics when he is concentrating, doing activities, or sleeping.

  • At times, your child may be able to stop a tic from occurring. This may cause discomfort or a feeling of pressure in his body, causing him to have many tics afterwards.

  • As your child grows older, his tics may go away on their own.

What other problems might my child have? Children with TS are more likely to also have attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), or bipolar disorder. Ask your child's healthcare provider for more information on these disorders. Your child may also experience the following:

  • Being teased or bullied by other children

  • Embarrassment about his tics, or low self-esteem

  • Pain when he has certain motor tics

  • Temper tantrums, bullying other children or animals, or harming himself

  • Trouble sleeping, bad dreams, or sleepwalking

  • Trouble learning in school

How is TS diagnosed? Your child's healthcare provider will ask questions about your child's tics and health history. Tell him when the tics started, how often they occur, how bad they are, and if they interfere with daily activities. Tell him if a family member has TS or another tic disorder. Your child's healthcare provider may do testing to check your child's brain function. He may check your child's eyes, strength, memory, and problem solving ability.

How is TS treated? Stress may make your child's TS worse. Deep breathing, muscle relaxation, meditation, and listening to music can help your child cope with stressful events. The following therapies can also help your child manage his symptoms and decrease stress:

  • Medicines may be given if your child's tics are painful, harmful, or make it hard for him to do his normal activities. The medicines used to treat your child will depend on what other conditions he has. Medicines may be given to help decrease your child's tics. Some of the medicines may also help control anxiety, mood swings, or aggressive behavior. Some medicines may also help your child sleep.

  • Biofeedback training helps your child to control how his body reacts to stress or pain. This training can help reduce tics by helping your child manage triggers that can lead to a tic.

  • Cognitive behavioral therapy (CBT) helps your child learn to control his behavior, thoughts, and emotions. CBT may help your child understand the tic disorder and help him cope with his symptoms.

  • Habit reversal therapy helps your child learn new behaviors to take the place of his tics. Your child learns to recognize when the urge to have a tic is building. He learns to choose an action he can do that will interrupt the tic. He may need to do the action for up to 3 minutes before the tic urge stops.

  • Relaxation therapy helps decrease your child's physical and emotional stress. Relaxation therapy may help your child learn to control his tics. Deep breathing, muscle relaxation, meditation, and listening to music can help your child cope with stressful events.

Where can I find more information?

  • Tourette Syndrome Association
    42-40 Bell Boulevard
    Bayside , NY11361-2820
    Phone: 1- 718 - 224-2999
    Web Address: http://www.tsa-usa.org

Call 911 for any of the following:

  • Your child tells you he feels like hurting himself or others.

  • Your child has hurt himself or someone else.

When should I seek immediate care?

  • Your child gets very upset, threatens someone, or is violent. This may include talking loudly, shouting, or becoming very demanding.

  • Your child has a high fever, muscle stiffness, and problems thinking.

  • Your child has new changes in his vision.

When should I contact my child's healthcare provider?

  • Your child is not sleeping well or sleeps more than usual.

  • Your child has trouble in school or becomes depressed or anxious.

  • Your child is having muscle spasms (twitching) or trouble walking.

  • Your child has new tics, or his tics are getting worse or preventing him from doing his normal activities.

  • You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.