Children with Tourette’s syndrome often suffer from discrimination because of their strange behavior, such as squinting, shaking their heads and shoulders, shaking their hands and nodding their heads, kicking and twisting their legs, and talking dirty, etc. In severe cases, children with Tourette’s syndrome also have throat noises and often involuntarily make unusual sounds such as “humming”, “ah” and “coughing”. “, “cough” and other abnormal sounds. As the disease worsens, the child will be hyperactive, have difficulty in learning, inattentive, anxious, and even hurt himself.
I. Causes of pathogenesis
The etiology of tic disorders in children has not been completely clarified. It is believed that children with special qualities are prone to form abnormal motor conditioned reflexes when they have various mental factors or imitate the actions of others.
Pathogenesis
During the development of children, the motor analyzer of the brain is highly excitable and prone to twitchy reactions, especially in children with special qualities, when there are various mental factors or imitation of others’ movements, such motor conditioned reflexes are easily formed and become pathologically inert. It may start as a reaction to certain stimuli, and then become habitual twitching over time.
1. Genetic factors
Transient tic disorder can have family aggregation, and tic disorder is more common in the family members of the affected children, so it is thought that it may be related to genetic factors.
2.Somatic factors
At the beginning, tics are often produced due to local irritation. For example, blinking due to ocular conjunctivitis and impingement irritation, nasal aspiration and facial muscle twitching due to rhinitis or upper respiratory tract infection. When the local disease factors are removed, the twitching symptoms continue to exist.
3.Physical factors
Children with tic disorder are generally not quiet, sensitive to people and things, neurotic, demanding and stubborn. They are often combined with psychological symptoms, such as headache, abdominal pain, unexplained fever, constipation, asthma, and enuresis.
4.Emotional factors
Often related to the family, common factors such as parents of the affected child too high learning requirements, too much blame, mothers often have neurotic, mentally not quiet. Excessive intervention causes emotional disorders in children, especially anxiety and tension, and twitching is the reaction of psychological conflicts in the motor system. Family arguments, parental divorce, death of a loved one, etc. It is also thought to be related to a history of motor activity restriction, such as excessive parental concern for the child’s safety or some early illness that limited the child’s activity. Mental stimulation can also be a trigger. The child may have recently suffered an accident, such as an illness, hospitalization, or a dangerous encounter. Or the child may watch stressful television or video programs, play stressful games such as video games, etc. The tics become a manifestation of psychological stress. This factor plays a major role in transient tic disorder.
5. Learning theory
The twitching may start as a conditioned avoidance response, such as blinking with a foreign object in the eyes, or learning some physical defect or pathology of other people, and later play an enhancing role due to external causes, so that habitual twitching is formed.
Third, the symptoms of tic disorder in children
The manifestations of tic disorder usually develop between the ages of 2 and 15, with more males than females, in a ratio of 3:1.
1. Simple motor tics
Such as blinking, tilting the mouth, nodding, pouting, nasal aspiration, tongue extension, facial muscle twitching, head shaking, shoulder shrugging, finger snapping, etc. occur alternately.
2. Complex motor twitches
Such as neck twisting, head shaking, leg kicking, hand flinging or limb twitching, etc.; eye turning, special expression caused by facial twitching, shoulder and arm or hand and foot making a certain posture. Such as suddenly reaching out to slap people, touching furniture, hitting one’s own body or dystonia posture such as rotating, jumping, jerking up or bending the waist and abdomen.
3.Simple vocal twitching
Such as clearing the throat, coughing, and making involuntary screaming sounds such as “uttering…” and “ahhhh…”. It can also be manifested as throat clearing, coughing, snorting, spitting, barking and other sounds.
4.Complex vocal tics
Inappropriate stress or constant mouthing of obscene words, some complex sentences, and also repetitive, stereotyped complete statements, with an impatient, capricious and irritable personality. This is often accompanied by a lack of concentration in class or a decline in grades.
Some children with Tourette’s syndrome may engage in self-harming behavior, such as plucking eyebrows and hair, and in serious cases, they may cut their wrists with a razor blade.
The dangers of children with Tourette’s syndrome
As children grow older, their social and interpersonal interactions expand and they have some emotional experiences, such as a sense of honor and responsibility. If the child does not receive timely and effective treatment, especially if the twitching is not controlled, it will seriously affect his interactions with classmates and peers, resulting in low self-esteem, social withdrawal, immature behavior, social impairment, stuttering, and character discipline problems, seriously affecting their social interactions and interpersonal relationships.
Frequent involuntary twitching and vocalization can easily distract children’s attention and make it difficult for them to keep their eyes on books, which affects their memory over time, causing them to fall behind in their studies and lower their grades. Children with Tourette’s syndrome often make obscene remarks, lie, skip classes, and are irritable, easily quarreling and fighting with classmates.
Many parents of children with Tourette’s syndrome are confused and even blame each other for the prolonged stress, self-blame and social isolation, leading to depression and anxiety, and eventually to marital breakdown.
The older the child is, the more difficult it is to treat and the slower the recovery process.