Possible Symptoms of Tourette Syndrome in Adults

Symptoms of suspected Tourette syndrome?

Hello, doctor.
I have a friend who is 26 years old, and after spending a long time together, I've noticed several symptoms that seem to suggest Tourette syndrome.
1.
He often makes a light coughing sound or clears his throat when he is not speaking, which can last continuously for about 10 minutes.
2.
He has a habit of shrugging one shoulder intermittently, not constantly, and sometimes this is accompanied by movements of his head and neck.
3.
He has mentioned that he has difficulty breathing and often needs to take deep breaths, which I found online could also be related to Tourette syndrome.
These are the main three symptoms I've observed, and I've noticed that the frequency seems to be relatively high, especially since I've been around him for a long time; someone who just met him might not notice.
I would like to ask if these symptoms could be considered Tourette syndrome.
If so, is he aware of these actions, or are they involuntary? Is there a way to treat or manage this condition through medical intervention? I'm considering whether to suggest he see a doctor, but if it cannot be treated, I wonder if it would be better not to mention it to avoid affecting his mood and self-esteem.
Thank you.

Tim, 20~29 year old female. Ask Date: 2024/03/19

Dr. Jiang Junyi reply Neurology

Hello Mr.
Tim,
You mentioned that one shoulder tends to shrug habitually, which may suggest Tourette syndrome.
However, if it does not affect your daily life, you can coexist with this condition peacefully.
It is generally recommended to maintain a regular lifestyle, with early bedtimes and wake-up times, ample outdoor exercise, and to reduce the intake of foods containing caffeine, such as chocolate and tea, as a prerequisite for all treatments.
1.
Supplementation with Vitamin B6, zinc, and probiotics.
2.
Cognitive Behavioral Therapy (CBT).
3.
Pharmacotherapy: If supplementation with Vitamin B6, zinc, and probiotics is ineffective or if the symptoms become more severe, such as causing disruptions in daily life, medication may be considered.
There are two specific options:
- Typical antipsychotics: Effective, but with a risk of side effects.
- Atypical antipsychotics: Effective, generally with fewer side effects.
4.
Local treatment with botulinum toxin (suitable for motor symptoms).
5.
Deep brain stimulation surgery.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2024/03/19

More Info

Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by the presence of multiple motor tics and one or more vocal tics. The symptoms typically manifest in childhood, but they can persist into adulthood. It’s important to understand that TS can present differently in adults compared to children, and the symptoms can vary widely in severity and frequency.

In your friend's case, the symptoms you've described—persistent throat clearing, shoulder shrugging, and occasional head or neck movements—could indeed be indicative of Tourette Syndrome. The throat clearing and coughing are examples of vocal tics, while the shoulder shrugging and head movements are motor tics. It's not uncommon for individuals with TS to have a combination of both motor and vocal tics.

Regarding your question about self-awareness, individuals with Tourette Syndrome often have varying degrees of awareness about their tics. Some may be fully aware of their tics and can sometimes suppress them for short periods, while others may not be conscious of them at all. This lack of awareness can lead to frustration or embarrassment, particularly in social situations, which may affect their self-esteem and confidence.

As for treatment, there are options available for managing Tourette Syndrome. While there is no cure, many individuals find relief through a combination of behavioral therapies and medications. Behavioral therapies, such as Comprehensive Behavioral Intervention for Tics (CBIT), can help individuals learn to manage their tics and reduce their frequency. Medications, such as antipsychotics or other drugs that affect neurotransmitter levels, can also be prescribed to help control tics.

It’s commendable that you are considering your friend's feelings before suggesting they seek medical advice. However, it’s important to approach the topic with sensitivity. You might start by expressing your observations in a supportive manner, emphasizing that you care about their well-being. You could mention that some people find it helpful to talk to a healthcare professional about their symptoms, as there are effective treatments available that can improve quality of life.

Encouraging your friend to seek help does not have to be framed as a negative thing. Instead, it can be presented as a proactive step towards understanding their experiences better and finding ways to manage any discomfort they may be feeling. It’s also worth noting that many adults with TS lead fulfilling lives, and with the right support, they can manage their symptoms effectively.

In summary, the symptoms you've observed in your friend could be consistent with Tourette Syndrome. It’s essential to approach the conversation with empathy and understanding, highlighting the potential benefits of seeking professional advice. By doing so, you can help your friend feel supported and empowered to take steps towards better managing their symptoms.

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