Tourette's Syndrome When Habit-Forming Systems Form Habits of Their Own?

dynamical methods may provide insight into the temporal features of tics that commonly are described clinically , such as short-term bouts or bursting and longer term waxing and waning. A deeper understanding of the multiplicative processes that govern these timing New Haven, Connecticut 06520 † Department of Psychiatry patterns may clarify both microscopic neural events occurring in millisecond time scales as well as macro-scopic features of the natural history of tic disorders. Motor tics typically begin between the ages of 3 and 8 with transient periods of intense eye blinking or some It's part of my nature. other facial tic. Vocal tics such as repetitive bouts of sniffing or throat clearing may begin as early as 3 years —Jim Eisenreich (1996) of age, but typically, they follow the onset of motor tics by several years. In uncomplicated cases, motor and Tic disorders have been the subject of intense specula-vocal tic severity peaks early in the second decade with many patients showing a marked reduction in tic sever-tion for at least the last three hundred years. Despite the overt nature of tics and thirty years of scientific ity by the age of 19 or 20 (Leckman et al., 1998). However , the most severe cases are adults. Extreme forms scrutiny, our ignorance remains profound. Notions of cause have ranged from " hereditary degeneration " to of this illness involve forceful bouts of self-abusive motor tics such as hitting or biting and socially stigmatizing the " irritation of the motor neural systems by toxic substances , of a self-poisoning bacteriological origin " to coprolalic utterances. Many patients with tic disorders report the presence " a constitutional inferiority of the subcortical structures …[that] renders the individual defenseless against over-of associated sensory phenomena including " faint " pre-monitory urges that incessantly prompt the tics and whelming emotional and dynamic forces " (Kushner, 1999). Predictably, each of these etiological explana-feelings of momentary relief that follow the performance of a tic (Bliss, 1980). Many patients describe these sen-tions has prompted new treatments and ways of relating to families. sations as being bodily feelings that are localized to discrete anatomical regions—like an urge to itch or a While tics are common in childhood, full-blown Gilles de la Tourette's syndrome (TS) is not. Boys are more need to clear one's throat. Other antecedent sensory phenomena include a generalized inner tension that can commonly affected than girls. The cardinal …