Term Paper: Tourette Syndrome the Human Condition Is Precarious

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Tourette Syndrome

The human condition is precarious at best and is hence often faced with myriads of psychological or cognitive disorders. Needless to say these disorders make the human condition just a tad more complex, thereby beckoning many questions as to how to decipher the many codes of the mind. Tourette syndrome is one such disorder which despite being rather rampant, can be said to have only recently been recognized as a genuine aberration. Like any cognitive disorder Tourette syndrome has certain genetic causes, basic symptoms or characteristics, adequate treatments and obvious effects on one's life. This report therefore, revolves around all these elements, in an attempt to understand the unpredictable and highly curious disorder.

The Tourette syndrome is named after George Gilles De La Tourette, a celebrated neurologist who laid the milestone of first discovering the symptoms of the disorder in 1885. (Olsen, 2004) it is a disorder which is defined as a neuropsychiatric condition and characterized by involuntary movements and actions often referred to as motor and phonic tics that range from mild to severe degrees. As such, a sufferer of Tourette syndrome is subject to "rapid, recurrent, non-rhythmic, stereotyped motor movements or vocalizations."(Diagnostic and Statistical Manual of Mental Disorders) Furthermore, according to DSM-IV this disorder is characterized by the sufferer fulfilling the various urges to move, mimic or even swear.

Tourette syndrome is rather difficult to identify and diagnose, primarily because the sufferers lead highly normal social lives and also because they mostly always suffer from some incremental disorder such as the Obsessive Compulsive Disorder (OCD) or the Attention Deficit Disorder (ADD). (Schroeder, 2005)(However, it cannot be assumed that this disorder is rare.) as such this disorder can be understood as being very divergent in its expression, yet has a definitely traceable line of causes.

When it comes to the causes of Tourette syndrome, we must first and foremost establish that this disorder is best understood if viewed from a neurological point-of-view. The basic neuropsychology of essential movement and behavior in human beings can explain the irregularities that bring forth the syndrome in question. Detailed study and extensive research over time proves that interconnected brain structures lying beneath the cerebral cortex, known as the basal ganglia, are responsible for the cognitive functioning of the brain. In other words, this structure is primarily responsible for integrating voluntary and involuntary actions with the rest of the body parts for consequential movement of muscles. (Olsen, 2004)

Volitional acts are thereby conducted by this part of the anatomy, and so it is natural to conclude that there is some unprecedented difference in this structure of a Tourette syndrome subject. Therefore, the motor cortex mentioned above issues certain commands to the brain to perform specific actions that a normal person can take for granted, such as standing up, sitting down, blinking or speaking. A Tourette syndrome subject is a specific case in point whereby this motor cortex is out of the individual's volitional control and hence issues needless and continuous commands to particular brain centers. (Schroeder, 2005) it is these unnecessary commands that make the person behave in a seemingly peculiar manner. (Buckser, 2006)

Many researchers have succinctly hypothesized that this condition is purely a result of genetic disposition which as we all know can only be predicted to a limited extent. The unpredictable causation can be attributed to random mutation just as much as obvious inheritance, but the occurrence of Tourette syndrome can definitely be attributed to the interplay of dominant and recessive alleles. Vulnerability or susceptibility to the Tourette syndrome gene largely arises from familial genotypes, such that parents with Tourette syndrome are most likely to pass on their condition to their generations. (Pauls, 2003) the onset can be observed early on in childhood, especially before the age of eighteen, and irregular behavior varies from person to person. (Sacks, 1992)but it is highly pertinent to note that patients with Tourette syndrome lead otherwise normal lives, as a matter of fact they can be credited for possessing completely normal intelligence as well as normal life expectancy. So, it would be a grand anomaly indeed to think that Tourette syndrome hinders a subject's life in any aspect.(Sims & Stack, 2009)

However, it must simultaneously be noted that a sufferer of Tourette syndrome may face incremental difficulties in the form of other psychological disorders. For instance, the sufferer may experience Obsessive Compulsion which is an anxiety related disorder whereby the subject performs certain repetitive behaviors to an obsessive extent such as counting. Similarly, the sufferer can also lapse into feelings of neglect when often told to try and control involuntary behavior, hence resulting in feelings of isolation, dejection or depression. This may not only result in disorders like Attention Deficit Disorder, Sleep Disorders and Bipolar Personalities, but may also go on to be a cause of extended social and emotional problems.(Brambilla)and of course the vulnerability to all these disorders only goes on to augment a sufferer's condition even more.

Due to this it is all the more significant to protect a sufferer of Tourette syndrome from all the possible implications that may show themselves in their lives. As Tourette syndrome is a genetically inherited condition, it is obvious that it cannot be treated and neither is it contagious. That is to say that its characteristics cannot be entirely eliminated. However, the vocal or behavioral irregularities or "tics" can most definitely be controlled such that the individual is able to function optimally and comfortably throughout his or her life. This can be accomplished through the promising option of therapy. Firstly, there is a pressing need to change the mindset of people and make them understand that Tourette syndrome does not entail any form of abnormality in a person. It should be one's quintessential objective to normalize the life of a sufferer as much as possible. (Zinner, 2000)

That being said, there are certain treatments which can indeed ease behavior if not eradicate it absolutely. Monotherapy and targeted combined pharmacotherapy are two premier methods of the treatment of associated behavior. Monotherapy is utilized when a single medication is administered to control a specific set of behaviors for instance vocal tics. Pharmacotherapy is the combined treatment of the various comorbid disorders that can come with Tourette syndrome, such as anxiety and depression. The basic purpose of such therapies is simply making life easier to cope with for the sufferer and of course minimizing whatever emotional obstacles are experienced by him or her.(Coffey, Berlin, & Naarden)

An important treatment intervention was conducted by Flaherty, et al. (2005) in which 37-year-old woman with severe Tourette syndrome since the age of 10 years was treated through brain stimulation of anterior internal capsule. Head and arm jerks of severe intensity resulting in unilateral blindness along with frequent vocalizations were general symptoms of the patient. Despite being medicated thorough 40 medications, the patient could not recover from the ailment. To cure the patient from this ailment, bilateral electrodes were implanted at the anterior limb of her interior capsule. The results were promising and displayed that such intervention is fruitful in case that careful procedures are followed as described in the study article.

The surgical technique being carried out to treat the patient was also described in detail in the study. Stereotactic MRI of brain along with computerized tomography of the patient was used to intervene and provide medication. Deep brain stimulation (DBS) through this method is reported to first such study being reported. The anterior internal capsule (AIC) of the brain is effectively reached at through this technique and where majority of the treatments had failed to generate positive results, the first intervention through DBS of AIC resulted in positive results for the mental health of the patient. The cognitive impairment in the patient can be effectively reduced if such periodic interventions are made on bi-yearly basis and an enabling environment is provided to the patient and intervening surgeons. On a side note, other observations were also reported din the study that had an indirect impact on the mental health of the patient.

It was reported in the study that different electrode settings resulted in a considerable change in the mood of patient. High voltage and low voltage stimulation in different parts of brain resulted in generation of different results. High voltage stimulation in nucleus accumbens region generated mild depression in the patient coupled with sense of apathy. Although these symptoms of treatment were not realized before the passage of several hours, once observed the results were reported to be significant for future researchers to carry on the research in same direction. The authors have also concluded that as opposed to ablation, cognitive stimulation can be incremental as well as adjustable. The intervention for restoring mental health of patients, as one mentioned by Flaherty, et al. (2005) is verified by other empirical studies as well. Shahed, et al. (2009) also verified the importance of DBS in restoring the mental and cognitive functions of a 16-year-old adult. The teenage was passing through… [END OF PREVIEW]

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