What should I do if my child yells obscenities? Alert to Tourette’s syndrome!

  Tourette’s syndrome, also known as Tourette’s syndrome, begins in children aged 3 to 10 years, most often aged 4 to 7 years, and is characterized by an involuntary, sudden, rapid, recurrent, non-purposeful, non-articulated movement or vocalization.  The main clinical manifestations are progressive development of multiple sites and various forms of motor tics and one or more vocal tics, and the co-existence of motor and vocal tics. The symptoms usually start with a single motor twitch of the eyes and face (blinking), which is intermittent, and then gradually progress to twitching of the neck, shoulders, limbs, and trunk (nodding, shrugging, striking, kicking, etc.), and persist.  The form of twitching also progresses from simple to complex, and finally obscene language appears. Vocal twitches usually appear 1-2 years later than motor twitches and are mostly simple vocal twitches, while complex vocal twitches are less frequent (sniffing, throat clearing, coughing, barking, “ahhh” sounds, etc.).  The tics and obscenities are frequent and affect the child emotionally and psychologically. About half of the children have obsessive-compulsive symptoms, half have attention deficit and hyperactivity disorder symptoms, and some have self-injurious behavior, mood disorders, or learning difficulties.  Tic symptoms can be aggravated by stress, anxiety, fatigue, excitement, cold and fever, and can be reduced by relaxation, full engagement in something, and disappear during sleep. The patient is not fully defined yet, and it may be the result of the interaction of genetic factors, neurophysiological, neurobiochemical and environmental factors.  Currently, in terms of treatment, there are medications and surgical treatments. Common medications include aripiprazole and haloperidol, many of which are also attempted treatments to try to improve some of the symptoms in some affected children. Medications can be started in small doses, slowly increasing the dosage to reduce side effects.  Combination medications can be considered when only partial symptom improvement is achieved with a single medication or when there are complex concomitant symptoms of Tourette’s syndrome. Take the medication to control the symptoms well and maintain it for a period of time, you cannot stop it immediately, you can try to reduce it slowly, you must use the medication under the guidance of a professional physician. If the symptoms are heavy and the effect of taking is not good, you can consider deep brain electrical stimulation treatment, which can improve the abnormal discharge pattern and improve the symptoms of the child by stimulating the relevant nuclei with microcurrent