Tourette Syndrome: Causes, Symptoms, and Treatment

Abstract

Tourette’s Syndrome (TS) is a neurological disorder characterized by the presence of motor and vocal tics. The exact cause remains unclear, but it is thought to involve a combination of genetic and environmental factors. TS is more common in males, with a male-to-female ratio of approximately 3:1. The typical age of onset is between 5 and 10 years, with tics often peaking in severity around ages 10-12. TS is frequently associated with other psychiatric and behavioral conditions, such as obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders. Many individuals experience symptom improvement or remission as they reach adulthood. Let’s discuss it in detail.

Introduction

Tourette Syndrome (TS) is recognized as one of the most heritable neuropsychiatric disorders, meaning it tends to run in families, though it follows a non-Mendelian inheritance pattern. This means the way it is passed down through families does not follow simple dominant or recessive genetic inheritance. One of the hallmark features of TS is the presence of motor tics, which are sudden, rapid, and repetitive movements that are involuntary and non-rhythmic. These tics often occur with a premonitory urge, where the individual feels a buildup of tension or discomfort that can only be relieved by performing the tic. Both motor and vocal tics are characteristic of TS and typically emerge in childhood. Some individuals experience significant improvement as they grow older.

Causes and Risk Factors

The exact cause of TS is not fully understood, it is believed to result from a combination of genetic, environment and neurological factors. Primary causes and risk factors of TS are as follow:

• Family history of psychiatric disorders such as OCD, ADHD or anxiety disorder.
• Brain abnormalities in basal ganglia and frontal cortex.
• Imbalance of dopamine, a neurotransmitter involved in motor control, is believed to contribute to TS.
• Certain infections, especially streptococcal infections, may trigger or worsen tics.
• Psychological and emotional stress during childhood cou;ld potentially trigger the symptoms of TS.
• TS is more common in males.

Types of Tics

Tics can be classified into two main types:

1. Motor tics – These tics are involuntary, repetitive movements that can affect various muscle groups in the body. These tics can be categorized into simple and complex types. Simple motor tics are quick, isolated movements like eye blinking or head jerking, while complex motor tics involve coordinated actions, such as jumping, touching objects, or performing repetitive motions like spinning. These tics are a key feature of Tourette Syndrome and can vary in severity.
2. Vocal tics – These tics are involuntary sounds or vocalizations, and they can be categorized as simple or complex. Vocal tics are involuntary sounds or vocalizations, and they can be categorized as simple or complex. Complex vocal tics involve repeating words or phrases, such as echolalia (repeating others’ words), palilalia (repeating one’s own words), or coprolalia (involuntary swearing, though rare).

Symptoms

It is a neurological disorder characterized by repetitive, involuntary movements and sounds known as tics. Symptoms include

1. Motor tics (physical movement)

   • Eye blinking
   • Head jerking
   • Shoulder shrugging
   • Arm or leg movements (flapping, kicking)
   • Jumping
   • Snapping fingers
   • Repetitive throat clearing

2. Vocal tics (sounds or words)

   • Throat clearing
   • Involuntary swearing (coprolalia)
   • Coughing
   • Sniffing
   • Grunting

Diagnosis

Diagnosing Tourette Syndrome (TS) involves a clinical evaluation based on the following

1. Medical history

   • Assessment of onset of symptoms
   • Family history

2. The diagnostic criteria for Tourette Disorder (DSM-5)

   • This criteria involves presence of multiple motor tics and at least one vocal tic for over a year, starting before age 18

3. Psychiatric evaluation

   • Screening of other condition like ADHD or OCD

4. Neurological exam

   • Checking of underlying brain issue

5. Expulsion of other conditions

   • Ruling out other causes

Management

Management of TS typically focuses on reducing tic severity and improving quality of life. Approaches include

1. Behavioral Therapy
   • Habit reversal training
   • Comprehensive Behavioral Intervention for Tics (CBIT)
2. Medications
   • Antipsychotics
   • Alpha-2 adrenergic agonists
   • Botulinum toxin
   • Anticonvulsants
3. Psychological support
   • Counselling
4. Lifestyle adjustments
   • Managing triggers
   • Reducing stress and fatigue
   • Rest

Ayurvedic aspect

In ayurveda, Tourette syndrome and its associated tics are often seen as the result of an imbalance in the Vata dosha and Manovaha Srotas. Vata dosha, which governs movement, nervous system and motor control, when vitiated, leads to overstimulation of the nervous system, causing involuntary movements like tics. This imbalance may arise from factors such as excessive stress, irregular routines, improper diet (cold and dry foods) and overexertion. Additionally, manovaha srotas (channels governing mental and emotional processes) can become disturbed when vata is aggravated, leading to emotional instability, anxiety, and impulsive behaviors, which are also characteristic of Tourette Syndrome. The imbalance in manovaha srotas also contributes to mental restlessness, which enhances the physical symptoms of tics, making them more frequent or intense. The excessive vata dosha causes erratic neural impulses. This results in involuntary physical movements or vocalization.

Management

The Ayurvedic treatment for Tourette Syndrome focuses on balancing the vata dosha, restoring the flow of the manovaha Srotas. Steps to manage the symptoms of tourette syndrome involves

1. Balanced lifestyle
   • Rest
   • Healthy diet including foods like cooked vegetables, whole grains, and healthy fats to balance vata
   • Avoid cold, dry foods, caffeine, and processed items
   • Meditation
   • Yoga
2. Herbs
   • Brahmi (Bacopa monnieri) – Reduce anxiety.
   • Jatamansi (Nardostachys jatamansi) – Relieves mental agitation.
   • Ashwagandha (Withania somnifera) – Supports the nervous system.
   • Shankhapushpi (Convolvulus pluricaulis) – Enhances mental clarity.
3. Panchakarma procedures
   • Abhyanga (oil massage) : To balance vata dosha, relieve tension, and calm the nervous system.
   • Shirodhara (pouring warm herbal oil over the forehead) : To reduce mental agitation, calm the mind, and ease stress.
   • Swedana (Fomentation) : To promote detoxification and balance the body’s energies.
   • Nasya (nasal administration of herbal oils or powders) : To improve mental clarity and focus.

Herbal Remedies For Tourette’s Syndrome by Planet Ayurveda

Planet Ayurveda provides a range of natural herbal solutions, including Neurogenie Capsule, Medhya Churna, Neuroplan Syrup, Brahmi Ghrit, and Stress Support, designed to help manage Tourette’s Syndrome. These products are crafted from premium-quality herbs and prepared following traditional Ayurvedic methods. Completely pure, vegetarian, and free from chemicals, preservatives, and additives, they offer a safe, side-effect-free alternative for supporting your health in a natural way.

Product description

1. Neurogenie Capsules – These capsules are formulated with natural herbs such as Brahmi (Bacopa monnieri) and Ashwagandha (Withania somnifera). These herbs are known for their cognitive-enhancing properties, thus they improve focus and mental clarity. These herbs provide calming effects that can help reduce stress and anxiety, which often exacerbate tics in Tourette’s. These capsules offers supportive benefits for managing certain symptoms of Tourette Syndrome

Dosage : 1 capsule twice a day, with water, after a meal.

2. Medhya Churna – This formulation contains a blend of herbs known for their cognitive and neurological benefits, such as Vacha (Acorus calamus), Ashwagandha (Withania somnifera), Shankhpushpi (Convolvulus pluricaulis), and Patha (Cissampelos pareira) among others. These herbs have been traditionally used to support brain health, reduce stress, and improve overall mental clarity. Vacha (Acorus calamus) enhances cognitive function and calms the nervous system, potentially reducing tics. Shankhpushpi (Convolvulus pluricaulis) boosts brain health and alleviates mental stress, while Patha (Cissampelos pareira) soothes the nervous system. These herbs collectively work to balance the Vata dosha, which governs movement and the nervous system in Ayurveda, promoting mental clarity, reducing stress, and potentially easing tics.

Dosage : 1/4 tsp twice with warm milk and scrub over the tongue too.

3. Neuro Plan Syrup – This formulation contains herbs like Brahmi (Bacopa monnieri), Mandukaparni (Centella asiatica), Jyotishmati (Celastrus paniculatus), Madhuyashti (Glycyrrhiza glabra), Bhojpatra (Betula utilis) and several other herbs. These herbs enhance memory, reduce anxiety, boost brain function, and improve mental clarity. Together, these herbs help manage tics by promoting mental balance and supporting brain health.

Dosage : 2 tsp twice daily.

4. Brahmi Ghrit – It is a classical Ayurvedic preparation made with Vacha (Acorus calamus), Kutha (Saussurea lappa), Brahmi (Bacopa monnieri), and cow’s ghee. It is beneficial for Tourette Syndrome by nourishing the nervous system and promoting cognitive health. Cow’s ghee acts as a carrier, helping to deliver the herbs’ benefits deep into the tissues. This formulation, as a rasayana (rejuvenating tonic), nourishes the body and mind, reducing stress and improving mental balance.

Dosage : 1 tsp twice daily with warm water.

5. Stress Support – These capsules contain herbs such as Ashwagandha (Withania somnifera), Tagar (Valeriana wallichii), and Brahmi (Bacopa monnieri). These herbs are beneficial in managing the symptoms of Tourette Syndrome. Together, these herbs work to balance the Vata dosha, potentially reducing the frequency and intensity of tics by calming the mind and promoting mental stability. Tagar (Valeriana wallichii) is known for its calming and sedative properties, promoting relaxation and improving sleep, which is important for managing the neurological aspects of Tourette’s.

Dosage : 1 capsule twice a day, with water, after a meal.

Conclusion

In this article we concluded about Tourette Syndrome. We discussed its causes or risk factors, types, symptoms, diagnosis, management, ayurvedic aspect and herbal remedies by planet ayurveda. Tourette’s Syndrome is a neurological disorder marked by repetitive, involuntary movements and vocalizations called tics. Although it can impact daily life, many individuals lead successful lives with proper support and understanding. Continued research, education, and awareness are essential to reduce stigma and improve treatment options for those affected by Tourette’s.