ADHD and Tourette Syndrome
What is Tourette Syndrome
Tourette syndrome may effect as many as 1 in every 100 people. Most people, however, have a mild form and may not seek or require treatment. Boys are diagnosed with tourette syndrome more often than girls and the average age of onset is normally between the ages of 7 and 10, although the most severe symptoms are often seen in the teen and late teen years.
Tourette syndrome is characterized by involuntary tics. Tics are repetitive movements or vocalizations. These can include common, simple tics such as eye blinking, shrugging shoulders or jerking of the head. Throat clearing or grunting sounds may be vocalization tics. Tics can also include several movements. These would be considered complex tics and can be shrugging shoulders combined with eye blinking or shrugging shoulders combined with a grunt or sound. Some people words rather than sounds (although less than 10% of people with tourette syndrome repeat curse words).
For most people with tourette syndrome, tics do not cause impairment in everyday life and no treatment is required. For some, however, tics are severe enough to interfere with daily activities. Medication to suppress tics is then prescribed, however, medication does not cure tourette syndrome or eliminate all symptoms.
Tics are not caused by psychological reasons but people with tourette syndrome may experience emotional and social problems as a result of tics and may benefit from psychotherapy to find ways to cope with the stress that often accompanies tourette syndrome. In addition, recent research has also shown that behavioral techniques may be able to help people control some tics temporarily.
Tourette Syndrome and ADHD
Recent research has shown that 90% of people with tourette syndrome also have another disorder, the most common co-existing condition being ADHD with some reports indicating that as many as 60% of people with tourette syndrome also have ADHD.
Previously, stimulant medication, used to treat symptoms of ADHD, were thought to cause increased tics and the medication was stopped when tics were present. This information, however, is considered to be outdated. Stimulant medications, when prescribed in high doses, may temporarily make tics worse, however, it has been found to have no impact on tics when prescribed in low or moderate doses.
As with most co-existing conditions, the condition causing the most impairment in daily life is usually treated first. Often, it is the ADHD that is first diagnosed and first treated, as ADHD may cause more impairment in school as well as in emotional development and social situations.
According to a study published in the Journal of Developmental and Behavioural Pediatrics, by the University of Calgary and University of Toronto, children exposed to risk factors during pregnancy including maternal smoking, premature birth, and low birth weight were two to three times more likely to develop tourette syndrome and these factors may play a role in the development of ADHD as well.
The study indicated that these risk factors are among those within the control of the mother and taking precautions such as receiving prenatal care, eating properly and not smoking during pregnancy could lower the risk of tourette syndrome.
For more information:
"AD/HD and Coexisting Conditions: Tics and Tourette Syndrome", 2005, National Resource Center on AD/HD, Children and Adults with Attention-Deficit Hyperactivity Disorder
"Tourette Syndrome Fact Sheet", Updated 2008, July, National Institute of Neurological Disorders and Stroke
"People Often Experience Both Tourette and ADHD Combined", 2009, April 17, Medical News Today