Understanding Tourette Syndrome: Causes, Symptoms, And Treatment Options
Tourette syndrome is a condition characterised by movements or sounds known as tics. Tics are involuntary and can range from simple twitches to complex patterns. While it can be challenging to diagnose and treat, understanding this condition is crucial to provide support and access to appropriate treatment.
Understanding and support are vital for those dealing with Tourette syndrome. This article aims to dispel misconceptions, explore causes, symptoms, and treatments, while offering empathy and insight into its impact at different life stages.
Lastly, we share financing options for treatment in Singapore so that those afflicted by this condition can gain access to the help they need. Together, let's delve deeper into the intricacies of Tourette syndrome and discover ways to support those affected by this condition.
What Is Tourette syndrome?
Tourette syndrome is a neurological disorder that causes repetitive and involuntary movements or sounds known as tics. These tics can vary in severity and can significantly interfere with communication and daily functioning.
Tourette syndrome usually appears in childhood, between ages 2 and 15, with the average onset around 6 years of age. It affects both males and females, but males are about three to four times more likely to develop Tourette syndrome.
While there is no cure for Tourette syndrome, treatments are available, and tics often lessen in frequency or become easier to control after individuals afflicted with the condition become teens.
Common Misconceptions About Tourette Syndrome: Separating Fact from Fiction
According to Tourette Association of America, there are a few common myths and misconceptions that surround Tourette.
Myth #1:
Tourette syndrome leads everyone to blurt out obscenities.
Fact:
Only 10% of individuals with Tourette syndrome experience coprolalia, the involuntary use of foul language. It's crucial to dispel this myth to prevent prejudices.
Myth #2:
Everyone with tics has Tourette syndrome.
Fact:
Tics vary in complexity and duration. Tourette syndrome requires a history of a few motor tics and at least one vocal tic for over a year, while other tic disorders have different criteria.
Myth #3:
People with Tourette syndrome can control their tics if they try hard enough.
Fact:
Tics are thought to arise from altered brain function, making them involuntary. Though some may be able to suppress tics temporarily, it's not a lasting solution.
Through behavioural therapy, some may also be able to manage their symptoms better. But generally, controlling tics is difficult and is not a matter of how much effort someone puts in.
Myth #4:
No visible tics mean improvement.
Fact:
Individuals with Tourette syndrome may hide tics to fit in, but it doesn't mean they're cured. Symptoms can fluctuate over time, so a lack of tics does not necessarily mean someone is doing better.
Myth #5:
Tourette syndrome is caused by stress or an unhappy childhood.
Fact:
Tourette syndrome has a significant genetic component and is not solely caused by stress. Factors like genetics and environmental aspects such as exposure to smoking for pregnant women play a role too.
Myth #6:
Tics occur only in children.
Fact:
Tics are more commonly seen in children, with some studies estimating that six in 1000 children are diagnosed with Tourette syndrome. However, they occur in all age groups.
Additionally, tics can persist into adulthood, ranging from mild to severe. Tourette syndrome diagnosis requires onset before 18, but it affects all age groups.
Myth #7:
People with Tourette syndrome are less intelligent.
Fact:
Intelligence is not impacted by Tourette syndrome, but some individuals may have learning disabilities or comorbidities such as OCD, ADHD and anxiety disorder that require adjustments for their needs.
Myth #8:
People with Tourette syndrome can't lead normal lives.
Fact:
While Tourette syndrome can be challenging, many individuals lead fulfilling lives, achieving success in school and the workplace.
Myth #9:
Tourette syndrome affects specific ethnic groups more.
Fact:
Tourette syndrome does not show racial or ethnic preference; it can affect anyone regardless of background.
Unravelling The Causes And Risk Factors Of Tourette syndrome
Risk factors:
- Family history: Having a family history of Tourette syndrome or tic disorders may increase the risk of developing Tourette syndrome.
- Sex: Males are three to four times more susceptible to Tourette syndrome than females.
While the precise causes of Tourette syndrome remain unknown, research suggests a significant genetic role. Tourette syndrome appears to be a genetically complex disorder, influenced by multiple interacting genes and environmental factors such as smoking during pregnancy or pregnancy complications.
Shedding Light On The Symptoms Of Tourette syndrome
Tics are categorised into two types:
Simple tics: Sudden, repetitive tics involving limited muscle groups.
Complex tics: Distinct, coordinated movements involving several muscle groups.
Tics can be either motor (involving movement) or vocal (involving sounds). Motor tics often appear before vocal tics, but the range of tics experienced is diverse.
Frequently seen simple motor tics include:
- Blinking
- Jerking your head
- Shrugging your shoulders
- Darting your eyes
- Twitching your nose
- Moving your mouth
Frequently seen complex motor tics include:
- Touching or smelling things
- Repetitive actions that have been observed from others
- Stepping in a certain pattern
- Obscene gestures
- Bending/twisting
- Hopping
Frequently seen vocal tics include:
- Grunting, coughing, throat clearing, and barking
Frequently seen complex vocal tics include:
- The repetition of your own or others’ speech and the use of profanities
If you notice your child having involuntary tics, bring them to see a paediatrician as soon as possible to identify the cause. This is because Tourette syndrome can also be associated with other conditions, including attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), autism spectrum disorder, learning disabilities, sleep disorders, depression, anxiety disorders, and anger-management problems.
Diagnosis And Evaluation
Tourette syndrome is typically diagnosed through a process of history taking and observation, as there are no specific diagnostic tests for this condition.
International standards for diagnosing Tourette syndrome require that a child or young person must have multiple motor tics and at least one vocal tic that occur regularly, even if not simultaneously, for more than a year. The individual must also be under 18 years old and not have any other conditions that could explain the tics.
Diagnosing Tourette syndrome can be challenging since tics may resemble symptoms of other conditions like allergic rhinitis or chronic cough. Unfortunately, symptoms have often been misunderstood as behavioural difficulties or bad habits, which is not the case.
Obtaining a confirmed diagnosis is essential as it allows the individual and those around them to learn about and comprehend the disorder. With additional information and support, patients can better cope with Tourette syndrome and its impact on daily life, social interactions, and overall well-being.
Managing Tourette syndrome In Different Life Stages
Childhood: School Accommodations and Peer Relationships
During childhood, managing Tourette syndrome involves finding an appropriate school with the right learning environment to support the child's learning and social experience.
Educators and parents can work together to create a conducive learning environment that considers the child's unique needs. Open communication with teachers and peers about Tourette syndrome can foster understanding and reduce misconceptions, leading to more inclusive peer relationships.
Adolescence: Transitioning to Adulthood and Self-Advocacy
As adolescents with Tourette syndrome approach adulthood, they may face the challenges of transitioning to more independent living and decision-making.
Encouraging self-advocacy skills is crucial, empowering them to communicate their needs, seek support, and make informed choices about their healthcare. Building a strong support network of friends, family, and professionals can assist in navigating this transitional phase.
Adulthood: Career Considerations and Managing Stress
In adulthood, individuals with Tourette syndrome need to consider career choices that align with their strengths and accommodate their needs. Pursuing professions that allow for flexibility and understanding can positively impact job satisfaction.
Implementing stress management techniques, such as mindfulness and relaxation strategies, can help in coping with the demands of the workplace and daily life. Developing a healthy work life balance is essential for overall well-being.
Treatment Options
1. Medication
The primary goal of medication in treating Tourette syndrome is to reduce tics, alleviating distress and interference with daily functioning. While medications do not offer a cure and tics may not completely disappear, they can help manage symptoms. Tics may still fluctuate in frequency and severity, regardless of medication use.
Finding the right medication or combination for each individual may involve trial and error, as responses vary. It's important for doctors to carefully weigh potential benefits against risks and monitor patients for adverse reactions.
2. Behavioural Therapy
Comprehensive Behavioral Intervention for Tics (CBIT) offers a non-medicated approach to managing Tourette syndrome. It comprises three key components: increasing awareness of tics and urges, training patients in competing behaviours to counter tics, and making positive changes in daily activities to reduce tics.
CBIT incorporates effective strategies already used in Tourette syndrome management. Adults with Tourette syndrome often develop similar coping techniques. This therapy aims to teach techniques quickly, helping patients gain better control over their tics.
Habit reversal, a part of CBIT, focuses on managing specific tics in outpatient sessions with psychiatrists or psychologists. Regular monitoring of tic frequency and triggers is often practised by children and adolescents with tics. As individuals age, tics may become less severe.
Financing Options For Treatment
1. MediShield Life
MediShield Life, a basic healthcare insurance plan in Singapore, covers Singaporeans and PRs. It provides coverage for up to 35 days of psychiatric inpatient care per year, with a claim limit of up to $100 per day. To enhance coverage, individuals can consider purchasing an Integrated Shield Plan (IP), which offers more extensive benefits for psychiatric hospitalisation, outpatient treatment, and diagnostics. Depending on the IP, patients may have access to B1 wards, A wards, or private hospitals.
2. Medisave
Medisave, another government scheme in Singapore, is not health insurance, but it helps with medical expenses. In addition to MediShield or Integrated Shield coverage, individuals can use their Medisave funds to pay for psychiatric hospitalisation, with daily limits of up to $150 and an annual limit of $5,000.
3. Medifund
Medifund is an endowment fund established by the government to provide financial assistance to those facing difficulties in paying their medical bills. To be eligible, individuals must be Singaporean citizens, have received treatment from a MediFund-approved institution, have received subsidies for healthcare costs, and still face financial distress after utilising MediSave, MediShield, and cash. This safety net aims to help patients in Singapore, including those with conditions like Tourette syndrome, who may struggle to cover all their expenses due to financial constraints.
4. Income's Star Secure Pro
Income's Star Secure Pro1 is a comprehensive whole life insurance plan offering protection against death, total and permanent disability, and terminal illness. The Early Life Accelerator rider2 add-on also provides coverage for specific mental health conditions such as Tourette syndrome, Major Depressive Disorder, Obsessive Compulsive Disorder, Schizophrenia, and Bipolar Disorder.
Empowering Lives With Income's Star Secure Pro
In the journey of navigating mental health challenges like Tourette syndrome, having a safety net becomes paramount. With Star Secure Pro’s Early Life Accelerator rider2 add-on, the financial costs associated with mental health are alleviated. You can focus on your treatment, well-being and care, knowing that your financial concerns are taken care of.
1 Star Secure Pro includes a non-participating compulsory rider, Star Secure Pro – Protection Benefit. This rider pays accidental death benefit, Retrenchment Benefit, Family Waiver Benefit, and part of the minimum protection value. Please refer to the policy conditions for further details.
2 Income will pay no more than $30,000 for the same condition for each insured. Coverage before age 75 except Tourette syndrome before age 21. Policy Ts&Cs apply.
This article is meant purely for informational purposes and should not be relied upon as financial advice. The precise terms, conditions and exclusions of any Income Insurance products mentioned are specified in their respective policy contracts. For customised advice to suit your specific needs, consult an Income Insurance advisor. This advertisement has not been reviewed by the Monetary Authority of Singapore.
These policies are protected under the Policy Owners’ Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact Income Insurance or visit the GIA/LIA or SDIC websites (www.gia.org.sg or www.lia.org.sg or www.sdic.org. sg).
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