Tourette Syndrome

[Katy-Richards]

    
      Re: Tourette Syndrome
    


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Posted by CCF Neuro MD on July 25, 1997 at 19:37:55:

In Reply to: Tourette Syndrome posted by Katy Richards on July 14, 1997 at 23:07:02:

: I'm not sure if anybody can help at this point.  My son is 20 years old and has been diagnosed with tourette syndrome at the age of 10.  He has been on and off medication when living at home but has been placed out of the home since age 14 for out of control behavior including correctional facilities and now to prison.  The tics are the least of his problems.  He has no respect for authority figures and even resents anyone in that position and is verbally abusive.  He is easily angered  and doesn't seem to remember what he has said after an outburst.  I don't know if he is lying or really doesn't remember.   I am of the contention that he needs to be on medication but he has refused to take it anymore.  He is now at San Quentin Prison in California, serving yet another sentence for  a parole violation.  He always pushes the limits.  He is a handsome, strong  young man but seems determined to mingle with the wrong types of people.  Is there anything else I should be doing to help him overcome his handicap?  I feel so bad for him but am willing to allow him to suffer the consequences of his actions.
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To: Katy Richards,
     Sorry to hear about your son's problems over the years. Based on your description of events, I would agree with your assessment that tics are the least of his problems at this time. It sounds like he has had significant behavior problems for several years, but it is not clear what sort of prior assessments, medical therapy or behavioral interventions have been tried.
Hopefully, he has undergone full neurologic and psychiatric evaluation at some point, and has had good trials of medications that often are useful with some of the behavioral concerns (e.g prozac as an example, or some of the antiepileptic drugs that have useful behavioral effects).  Rage outbursts as you are describing can reflect anything from behavioral dyscontrol, to seizures and should be fully assessed to pinpoint the appropriate diagnosis.  On the other hand, sometimes when children have had chronic conditions such as Tourette's all their lives, they may have problems socializing in a normal fashion and this can be reflected in behavioral problems and antisocial traits.  In addition, although there is no solid evidence in this regard, there is a lot of speculation in the medical and psychiatric literature about the relationship between diagnoses such as Tourette's, attention deficit disorder or obsessive compulsive disorders (which can occur together) and antisocial behaviors or other, serious        
psychopathology.  The best approach at this time may be for you to be his advocate and ensure that he has had the proper neurologic and psychiatric evaluations, and that he has access to counseling services or other therapies suggested on the basis of such assessments. Beyond that, if he is 20 years old and mentally competent, you have no recourse if he does not take responsibility for his own care and refuses to take medications or comply with other recommendations.
He is fortunate to have you in his corner.  Best of luck with everything.
*NOTE:  This information is provided for general medical education only.  Please consult your physician for diagnostic and treatment options of your specific medical condition.