What is Tourette Syndrome?

Tourette syndrome (TS) is an inherited, neurological disorder characterized by repeated involuntary movements and uncontrollable vocal (phonic) sounds called tics. In a few cases, such tics can include inappropriate words and phrases.

The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who first described an 86-year-old French noblewoman with the condition in 1885.

The symptoms of TS generally appear before the individual is 18 years old. TS can affect people of all ethnic groups; males are affected 3 to 4 times more often than females. It is estimated that 100,000 Americans have full-blown TS, and that perhaps as many as 1 in 200 show a partial expression of the disorder, such as chronic multiple tics or transient childhood tics.

The natural course of TS varies from patient to patient. Although TS symptoms range from very mild to quite severe, the majority of cases fall in the mild category.

What are the symptoms?

The first symptoms of TS are usually facial tics -- commonly eye blinking. However, facial tics can also include nose twitching or grimaces. With time, other motor tics may appear such as head jerking, neck stretching, foot stamping, or body twisting and bending.

TS patients may utter strange and unacceptable sounds, words, or phrases. It is not uncommon for a person with TS to continuously clear his or her throat, cough, sniff, grunt, yelp, bark, or shout.

People with TS may involuntarily shout obscenities (coprolalia) or constantly repeat the words of other people (echolalia). They may touch other people excessively or repeat actions obsessively and unnecessarily. A few patients with severe TS demonstrate self-harming behaviors such as lip and cheek biting and head banging against hard objects. However, these behaviors are extremely rare.

Tics alternately increase and decrease in severity, and periodically change in number, frequency, type, and location. Symptoms may subside for weeks or months at a time and later recur.

How are tics classified, you say?

There are two categories of tics: simple and complex. Simple tics are sudden, brief movements that involve a limited number of muscle groups. They occur in a single or isolated fashion and are often repetitive. Some of the more common examples of simple ticsinclude eye blinking, shoulder shrugging, facial grimacing, head jerking, yelping, and sniffing. Complex tics are distinct, coordinated patterns of successive movements involving several muscle groups. Complex tics might include jumping, smelling objects, touching the nose, touching other people, coprolalia, echolalia, or self-harming behaviors.

Can people with TS control their tics, you wonder?

People with TS can sometimes suppress their tics for a short time, but the effort is similar to that of holding back a sneeze. Eventually tension mounts to the point where the tic escapes. Tics worsen in stressful situations; however they improve when the person is relaxed or absorbed in an activity. In most cases tics decrease markedly during sleep.

What causes TS?

Although the basic cause of TS is unknown, current research suggests that there is an abnormality in the gene(s) affecting the brain's metabolism of neurotransmitters such as dopamine,serotonin, and norepinephrine. Neurotransmitters are chemicals in the brain that carry signals from one nerve cell to another.

Such a condition made life harder on the young LJ. He had to try twice as hard in school and got in a lot of fights with other kids who would make fun of him over his TS. But through it all, his grandfather was there for him. Three years later when LJ was twelve, he lost his grandfather to a heart attack and begun to go into a deep depression for a while. At age fifteen, his grandmother passed away. It was during this time LJ begun to grow into the man he would become. Deciding that he would not let the TS control his life, he would become the man his grandfather would want him to become.

[Rest Land Cemetery in Dallas, Texas, February 23, 2003, 11:55 PM - The night sky is overcast. Dark clouds threaten rain and a slight wind blows a chill through the air. Standing above two gravestones that read Troy and Margaret, the last names obscured by shadows is a man we recognize as LJ Black. He is wearing a black leather trench coat, black slacks and black leather shoes. He stands over the grave shivering slightly as the night air and light wind gives his bones the slightest chill. With a somber look on his face, LJ kneels before the graves of his grandparents and lays the rose on the ground between in front of the gravestones. He places his fingers to his lips and makes a kissing movement, placing his two finger on his grandmother's grave stone before rising and standing over the two graves.]

LJ: Grandma, Grandpa. I hope you are looking down on me. I have not disappointed the two of you. I have so much I wish to share with you. A lot of people think I am an evil man, but I am just doing as you always told me, Grandpa - watching out for only number one and those closest to me. I just wish you were here with me. I have what could possibly be the biggest week of my life coming up and the Tourette's have begun to flair up on me from all the pressure. Dr. Narden has prescribed medicine to help me. To be honest, I am more happy than anything else. My plans have begun to fall into place. I have played everything as you taught me, keeping it close to the vest until I am ready to show my hand. If only I knew you were proud of me, it would make everything I have done worth it.

[A creaking sound on the damp grass can be heard in the quite of the night causing LJ to turn to see who approaches him. A look of shock crosses his face and his eyes go wide in shock. His mouth is wide open, but no words come out as he looks at the older, slightly balding man with gray hair wearing a black suit and tie smoking a cigar stands in front off him. He pulls the cigar from his mouth and exhales, blowing smoke in the cool night air, smiling at the younger man who stands before him unmoving like a statue.]

GP: Don't you have anything to say to your old grandpa, Bubba?

LJ: Grandpa? It can't be. This must be a dream. This is impossible.

GP: Does it really matter? Dream or not, I am here for you whenever you need me, Bubba. So, you have a big week coming up. Not only are you one of the richest men in the world, but come Tuesday night you will win the GDW Terror Championship.

[The two men embrace in a hug, tears falling down LJ's face at the joy of seeing his beloved grandfather once more. He finds himself wishing this moment would never end as he slowly pulls away, staring at his grandfather in awe.]

LJ: Grandpa, facing Laivindil Rayne at Valentines Fray is going to be a challenge. I want Trin at ringside with me but I am worried after last week she nearly got hit when KID leaped at me from the ring post.

GP: If you love Trin, you will treat her as an equal and not hold back. I know you worry since she is pregnet with your child.

LJ: You know about that?

GP: Of course I do. I am always looking down on you watching over you.

LJ: Yes sir, I am just worried about this match is all and a bout Trin . I would do anything for Trin and the world knows it.yet because how I treat less important people, I am booed as the villain. I do not care what the people think of me, but right now that is not important. You are here. That is what is important.

Voice: I am proud of you for sticking by your lady love and wanting to protect her.

[LJ spins around and sees an older woman who is about 5'2" with short black, slightly graying hair. She is wearing a white dress and sliver rimmed glasses. A smile breaks out across his face as he takes the woman in his arms, hugging her tightly and kissing her cheek.]

LJ: Grandma, I missed you so much! This is the best night ever. I am so glad to see you both.

[LJ's grandmother kisses his cheek and looks at him with a stern look on her face. She looks him up and down before speaking again.]

GM: Have you lost weight, Larry Wayne?

GP: Leave the boy alone, mama.

LJ: Grandma, I am in perfect shape, the best shape of my life. I'm in better shape than Laivindil Rayneand he will be in no shape after Tuesday.

GM : I hate seeing you in this business. You are rich. Why must you do this, Larry Wayne?

LJ: Grandma, I love doing this and I am good at it.

GP: Tell the boy how proud you are of him, how you scream at the screen for him to kick butt when we watch him on T.V.

[Grandma swats Grandpa on the right arm and turns to LJ, smiling brightly.]

GM: Hush up, papa. Yes, we are very proud of you. We get GDW where we are at now and we watch you all the time. I expect you to kick Laivindil Raynes�butt this week and bring home the Terror title. We have to go now, but we will be watching over you always. We love you.

GP: Never forget just how proud I am of you, Bubba.

LJ: I love you both.

[LJ hugs both his grandparents and closes his eyes. When he opens them again, there is a thick fog covering the area and he finds himself once more alone left to wonder if it was all a dream or something more.]