What are the causes of Tourette syndrome? Why insults?

Gilles de la Tourette syndrome is a neurological disease responsible for spasms. THE Scottish singer Lewis Capaldi revealed he had it during a live on Instagram in September 2022. “It happens all the time (spasms, editor’s note), When I’m excited, happy, nervous or stressed“ he explained. June 27, 2023 on Instagramhe announced “to make a break” on his tour: “I’m still in the process oflearn to adapt to the consequences of my Tourette syndrome“ he continued, recognizing that he must “dedicate a lot more time to my mental and physical health”This disease is very disabling but where is she from ?

What is Gilles de la Tourette syndrome?

“Gilles de la Tourette syndrome (GTS) is a complex neuropsychiatric disorder, with a genetic component, characterized by motor, sound and vocal tics”, explains it Dr Henri Rubinstein, neurologist, doctor of medicine and specialist in the functional exploration of the nervous system. First described in the 19th century by the French neurologist Georges Gilles de la Tourettehe would touch one person in 2000 in France.

What are the causes of Tourette syndrome?

Gilles de la Tourette syndrome is a neurological disease whose exact causes are currently unknown. Nevertheless, the genetic factor is often cited to explain its occurrence. The disease could also be due to a defect in the metabolism of certain neurotransmitters. “It would find its origin in theinability to effectively manage emotions due to thalamus dysfunction. We also mention phenomena of disinhibition of the frontal lobe, the area of ​​the brain that controls behavior and behavior”, says Dr. Rubinstein. THE environmental factor also seems to play an important role: toxic factors, immune reactions or stress could play a role.

What are the symptoms of Tourette syndrome?

SGT is characterized by “a set of neurological symptoms including inappropriate behaviors. These manifestations are accompanied by language tics, insults, involuntary muscular movements, sometimes grotesque facial expressions, etc..”, explains Dr. Rubinstein. “Generally, muscular tics appear first, followed by sound tics”, he adds. Motor tics correspond to involuntary and sudden movements, due to muscular contractions:

• Eye blinks;
• Head shaking;
• Shoulder shrugging (simple motor tics);
• Other actions such as obscene gestures (complex motor tics).

Motor and sound tics

Motor tics are generally accompanied by sonic tics, emitted by the mouth or nose:

• Throat clearing;
• Cries, laughter;
• Word repetition;
• Use of foul language, insults.

In more severe forms of TS, a person may also develop other symptoms :

• Behavioral disorders;
• Self-harm;
• Attention deficit;
• Hyperactivity;
• Panic or rage attacks;
• Obsessive-compulsive (OCD), sleep or learning disorders.

Why does Tourette syndrome cause insults?

Generally, Gilles de la Tourette syndrome is associated with coprolalia (to say profanity and insults) and at the copropraxia (make rude gestures). “Insults, often violent and/or inappropriate to the situation experienced, are among the usual symptoms of Gilles de la Tourette syndrome”, comments Dr. Rubinstein. However, not everyone with TS manifests not necessarily these symptoms.

Is Tourette syndrome linked to autism?

In 2019, a team of scientists discovered that the Gilles de la Tourette syndrome and autism may share the deletion (genetic mutation characterized by the loss of genetic material on a chromosome) of a region of chromosome 2 carrying a gene essential for the proper functioning of the thalamus. A link which undoubtedly exists due to a genetic alterationexplains Dr. Rubinstein: “The deletion of chromosome 2p16.3 is often the cause of developmental delay and learning difficulties. It is established that patients who present this genetic anomaly have a 15-fold increased risk of developing autistic disorders (ASD) and a 20-fold increased risk of developing Tourette’s syndrome.

Age: the syndrome occurs on average around the age of 7

Disease often appears in childhoodon average around the age of 7. It progresses in stages, with more or less long phases of remission, which can last up to one or even several years. “The disease affects between 0.05 and 3% of school-age childrenmore often boys than girls”, specifies Dr Henri Rubinstein. You should also know that symptoms such as motor, sound and vocal tics worsen during childhood and peak around the age of 11.

It is sometimes necessary to wait years before the diagnosis of Gilles de la Tourette syndrome is made. First, because it can be confused with many other illnesses such as simple tics or hereditary diseases associated with tics. TS can also be difficult to diagnose during adolescence and have severe repercussions in adulthood: “he often disappears during adolescence but can continue into adulthood, becoming a real handicap to social integration” comments Dr. Rubinstein. The diagnosis of Gilles de la Tourette’s disease is established after description and observation of motor and/or sound tics and their evolution. Certain specific criteria have been established:

• Presence of several motor tics and at least one audible tic at a certain time but not necessarily at the same time;
• Presence of tics several times a day, almost every day or intermittently for at least a year, with no tic-free interval for more than three consecutive months.
• There does not exist no medical examination specific to this neurological pathology. The doctor may request additional neurological examinations (CT scan, electroencephalogram) to rule out other diseases that could cause the same type of symptoms. No neurological abnormality is detected during traditional examinations: radio, MRI, scanner, electroencephalogram, etc.

There are no specific drug treatments

There does not exist no specific drug treatment for Gilles de la Tourette syndrome allowing complete recovery. “Many chemical molecules make it possible to alleviate the symptoms, without however curing them. explains Dr. Rubinstein. However, the disease can be support to alleviate behavioral problems the most disabling on a daily basis. A medical treatment can be offered in parallel, depending on the patient’s needs, but it should only be implemented when it is really necessary. Indeed, most medications cause side effects: weight gain, fatigue, depression, etc. Regular psychological care is recommended. It most often consists of a cognitive behavioral therapy (CBT). The medications prescribed are neuroleptics, which should be monitored for possible side effects. A adapted school follow-up may also be necessary in the event of learning disabilities.

Does hypnosis work?

“Hypnotherapy seeks to focus on the mechanics of the problem“, explains Dr. Rubinstein. “Free yourself from tics, master involuntary movements, learn relaxation, developing better management of emotions, improving self-control, strengthening self-image and self-confidence, are examples of possibilities What does hypnosis offer? to treat Gilles de la Tourette’s disease.he says. “A hypnosis session is broken down into several parts: the collection of information, the entry into trance, the hypnotherapy technique and the exit from trance. The session is followed by feedback intended to verify that everything goes well and that the requested change is part of a dynamic that respects the physical and moral integrity of the patient”, concludes Dr. Rubinstein.

Thanks to Dr Henri Rubinstein, neurologist, doctor of medicine and specialist in the functional exploration of the nervous system. Comments collected in 2021.