Tourette Syndrome Health Article

Treatment

Although there is no cure for TS, many alternative treatments may lessen the severity and frequency of the tics. These include:

• Acupuncture. In one study, acupuncture treatment of 156 children with TS had a 92.3% effective rate.
• Behavioral treatments. Some of these can help TS patients control tics. A large variety of these methods exist, some with proven success.
• Cognitive behavioral therapy. This form of therapy helps the patient to change his or her ingrained response to a particular stimulus. It is somewhat effective in treating the obsessive-compulsive behaviors associated with TS.
• Neurofeedback (electroencephalographic biofeedback). In neurofeedback, the patient learns to control brain wave patterns; it may be effective in reducing the symptoms of TS. There are, however, no data on this modality as a treatment for TS.
• Psychotherapy. This form of treatment can help the TS patient, and his or her family, cope with depression, poor relationships, and other issues commonly associated with TS.
• Relaxation techniques. Yoga and progressive muscular relaxation are believed to help TS, especially when used in combination with other treatments, because they lower the patient's stress level. One small study found that relaxation therapy (awareness training, deep breathing, behavioral relaxation training, applied relaxation techniques, and biofeedback) reduced the severity of tics, although the difference between the treatment group and control group was not statistically significant.
• Stress reduction training. This training may help relieve the symptoms of TS because stress worsens the tics.
• Other alternative therapies. Homeopathy, hypnosis, guided imagery, and eliminating allergy-provoking foods from the diet have all been reported as helping some TS patients.

Allopathic treatment

Most TS patients do not need to take drugs, as their tics do not seriously interfere with their lives. Drugs that are used to reduce the symptoms of TS include haloperidol (Haldol), pimozide (Orap), clonidine (Catapres), guanfacine (Tenex), and risperidone (Risperdal). One interesting recent finding is that the transdermal nicotine patch, developed to help people quit smoking, improves the control of TS symptoms in children who take haloperidol. Use of the patch allows the haloperidol dosage to be cut in half without loss of effectiveness in symptom control.

Stereotactic treatment, which is high-frequency stimulation of specific regions of the brain, was reported to be successful in significantly reducing tics in a TS patient who had failed to respond to other treatments.

Expected results

Although there is no cure for TS, many patients improve as they grow older, often to the point where they can manage their lives without drugs. A few patients recover completely after their teenage years. Others learn to live with their condition. There is always a risk, however, that a patient who continues having severe tics will become more antisocial or depressed, or develop severe mood swings and panic attacks.

Prevention

The only known way to prevent TS as of 2004 is for a couple not to have children when one of them has the condition. Any child of a TS parent has a 50% chance of inheriting the syndrome.

BOOKS

Landau, Elaine. Tourette Syndrome. Danbury, CT: Franklin Watts, 1998.

Leckman, James F., and Donald J. Cohen. Tourette's Syndrome—Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care. New York: John Wiley &Sons, Inc., 1998.

The Merck Manual of Diagnosis and Therapy. Edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

PERIODICALS

"Nicotine Patch Could Help Against Condition's Tics." Health & Medicine Week (October 8, 2001).

"Rate of Disease Much Higher Than Had Been Thought." Pain & Central Nervous System Week (November 19, 2001): 9.

Trifiletti, Rosario. "Antistriatal Antibodies in Tourette Syndrome: Not a Simple Story." Neurology Alert 20 (October 2001): 14.

ORGANIZATIONS

National Institute of Neurological Disorders and Stroke. National Institutes of Health. P.O. Box 5801, Bethesda, MD 20824. (800) 352-9424. <http://www.ninds.nih.gov>.

Tourette Syndrome Association, Inc. 42-40 Bell Boulevard, Bayside, NY 11361-2820. (718) 224-2999. Fax: (718) 279-9596. ts@tsa-usa.org. <http://www.tsa-usa.org>.

OTHER

"Tourette Disorder." Internet Mental Health. [cited October 2002]. <http://www.mentalhealth.com/fr00.html>.

Belinda Rowland

Rebecca J. Frey, PhD