Who is affected and how is the course?
The tics often occur several times a day, although the number, severity, type and location can also change. In some cases, they sometimes disappear over a longer period of time. With stress, tension and anger, but also joyful excitement they often increase. They can be kept under control by most Tourette patients, but this usually only means that their appearance is postponed but not prevented.
First symptoms mostly in childhood or adolescence
The disease almost always begins in childhood or adolescence, usually around the age of seven or eight. Frequently, the first signs are slight facial tics, such as the contortion of the mouth, blinking or eye pinching. The expression tends to increase until puberty, then - in about 70 percent of cases - or the tics disappear altogether. However, the course is very different in each case and does not allow prediction of the further prognosis. Most sufferers only suffer from a mild form.
Many people with a TS show additional behavioral problems. On the one hand, the overly frequent occurrence of an Attention Deficit Disorder on the other is compulsive or ritualistic behavior coupled with perfectionism. Some children have learning difficulties, and depression and sleep disorders can also occur. On the other hand, there are some TS patients who combine their urge to move with particularly good responsiveness and are so very successful in sports or the like. To what extent this occurs more frequently than with the average population is unclear.
How does the disease develop?
The exact cause of the TS is still unclear. However, it is now believed that there is a disorder in the area of certain nerve cells in the brain, the basal ganglia, which have important tasks in the design of movement. For the correct functioning they are dependent on transmitter substances, so-called neurotransmitters, above all dopamine, in addition, serotonin and others. If their metabolism is disturbed, there is an imbalance in the movement control. Incidentally, Parkinson's syndrome is an example of another disease underlying such a disorder.
Researchers agree that there is an inherited and non-hereditary form of TS. If parents, siblings or other relatives are affected, the likelihood of contracting a TS is increased. Boys are affected up to four times more frequently than girls. However, the genetic changes alone are probably not sufficient for the disease to break out, but other - not yet well known - factors such as environmental influences or infections must first interact with the genetic material. What triggers the non-hereditary form is unknown.