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"contents": "<figure class=\"align-right zoomable\"></figure>\r\nSee this <a href=\"https://www.youtube.com/watch?v=J5WS-0hrq3M\">You Tube link</a> of the Lewis Capaldi performance at Glastonbury shared via a fan.\r\n\r\n<strong>What is Tourette syndrome?</strong>\r\n\r\nNamed after 19th century researcher Gilles de la Tourette, Tourette syndrom is a neurological or neurodevelopmental condition.\r\n\r\nIt’s characterised by tics, which are involuntary movements or vocalisations.\r\n\r\nMany people have simple tics, especially children. But the official <a href=\"https://www.cdc.gov/ncbddd/tourette/diagnosis.html\">definition</a> of Tourette syndrome is motor and vocal tics nearly every day over more than 12 months.\r\n\r\nThere are two types of tics: motor tics and vocal tics.\r\n\r\nCommon motor tics often involve the head and neck. They can include things like:\r\n<ul>\r\n \t<li>eye blinking</li>\r\n \t<li>facial grimacing</li>\r\n \t<li>jerking the head and neck</li>\r\n \t<li>mouth movements</li>\r\n \t<li>shoulder jerks or jerking other parts of the body.</li>\r\n</ul>\r\nVocal tics can include:\r\n<ul>\r\n \t<li>throat clearing sounds</li>\r\n \t<li>humming sounds</li>\r\n \t<li>huffing or grunting</li>\r\n \t<li>sniffing</li>\r\n \t<li>high pitched squeals</li>\r\n \t<li>part of a word or syllable</li>\r\n \t<li>sometimes whole words or phrases.</li>\r\n</ul>\r\nSometimes in more severe cases of Tourette syndrome, people might have more complex tics and more orchestrated sequences of movements. This can include, for example, turning in a certain direction or tapping something a certain number of times. Often it’s a sequence that feels right for that person, which they have to complete to relieve tension.\r\n\r\n<p><img loading=\"lazy\" class=\"size-full wp-image-1745237\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2023/06/11557531.jpg\" alt=\"\" width=\"720\" height=\"436\" /> <em>Scottish singer-songwriter Lewis Capaldi performs on the Pyramid Stage at the Glastonbury Festival in Pilton, Britain, 24 June 2023. The Glastonbury Festival is a five-day festival of music, dance, theatre, comedy and performing arts running from 21 to 25 June 2023. EPA-EFE/ADAM VAUGHAN</em></p>\r\n\r\nInitially there is what we call a “premonitory urge”. It’s like an itch or the feeling you get before you sneeze. There’s a build-up up of tension and it’s relieved by the expression of the tic.\r\n\r\nPeople are often able to recognise this feeling prior to the tic and that’s an important part of tic management.\r\n\r\nTics usually have onset in childhood, typically in the early primary school years, but occasionally later in life.\r\n\r\nTourette syndrome often runs a frustratingly waxing and waning course. There may be periods where it’s not noticed for weeks or even months and then it comes back.\r\n\r\nSometimes tics get worse in response to stress, like the start of a new school term or moving house. Sometimes they get worse for no reason at all.\r\n\r\nThere can be an element of suggestibility; talking about a tic can bring on that tic.\r\n\r\nThere’s also a degree of suppressibility. People with tics can either subconsciously or consciously suppress them. Kids often don’t have many tics at school because they know they might get teased, but after school the parent often sees a lot of tics come flowing out.\r\n\r\nPeople can often camouflage tics. For example, if they have an urge to jerk their arm, they may scratch their chin and transform it into something else. That’s often a part of treatment or a method their team may work with them on.\r\n\r\n<strong>How is it treated?</strong>\r\n\r\nOften we don’t need to do anything about Tourette syndrome because it’s not causing problems in terms of a person’s self-esteem or their broader life. They can still hold a pen or a spoon and it’s not affecting their day-to-day function.\r\n\r\nMost cases are not severe and the tics don’t need any intervention.\r\n\r\nBut many kids with Tourette syndrome also have other conditions such as ADHD, OCD and anxiety. So if the Tourette syndrome isn’t causing harm the paediatrician may be more concerned about treating those issues first.\r\n\r\nThe marker for Tourette syndrome needing treatment is whether it’s bothering the child.\r\n\r\nIf it is, we consider what we can do about the tics themselves. They are quite hard to treat.\r\n\r\nA psychologist will usually work on general anxiety management strategies, as anxiety can be a significant driver of tics.\r\n\r\nThere is also a treatment strategy known as <a href=\"https://www.cincinnatichildrens.org/health/t/tic-intervention#:%7E:text=CBIT%20is%20an%20established%20therapy,and%20worse%20on%20their%20own.\">comprehensive behavioural intervention for tics</a>, which is a dedicated program to help people manage their tics. But it can be difficult to access due to availability.\r\n\r\nThere are medications for severe cases but they’re not very effective at reducing tics and can cause side effects.\r\n\r\n<strong>Why do some people get Tourette syndrome?</strong>\r\n\r\nWe think Tourette is largely <a href=\"https://pubmed.ncbi.nlm.nih.gov/28150698/\">genetic</a>.\r\n\r\nIt’s nothing to do with anything the parents have done or the child has done, and it’s not caused by anything that happened during pregnancy.\r\n\r\nIt’s not one gene that causes it but rather a combination.\r\n\r\n<strong>Reducing stigma is key</strong>\r\n\r\nTourette syndrome is, by nature, a highly stigmatising condition because at the severe end people can do very unusual things and draw attention to themselves, through no fault of their own, which can cause embarrassment.\r\n\r\nOne thing we can do for kids, if they are able to, is suggest they go to their school with the support of a carer or parent and talk to classmates about their Tourette. They explain what it is and why they can’t help it. Often that can lead to more acceptance from other kids.\r\n\r\nMost people with Tourette syndrome can live normal lives.\r\n\r\nEducation is key to reducing stigma. The <a href=\"https://tourette.org.au/\">Tourette Syndrome Association of Australia</a> has some great information and resources. <strong>DM</strong><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines -->\r\n\r\n<a href=\"https://theconversation.com/profiles/daryl-efron-13585\">Daryl Efron</a>, Associate Professor, department of paediatrics, <em><a href=\"https://theconversation.com/institutions/the-university-of-melbourne-722\">The University of Melbourne</a></em>\r\n\r\nThis article is republished from <a href=\"https://theconversation.com\">The Conversation</a> under a Creative Commons license. Read the <a href=\"https://theconversation.com/what-is-tourette-syndrome-the-condition-lewis-capaldi-lives-with-200630\">original article</a>.",
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"name": "Scottish singer-songwriter Lewis Capaldi performs on the Pyramid Stage at the Glastonbury Festival in Pilton, Britain, 24 June 2023. The Glastonbury Festival is a five-day festival of music, dance, theatre, comedy and performing arts running from 21 to 25 June 2023. EPA-EFE/ADAM VAUGHAN",
"description": "<figure class=\"align-right zoomable\"></figure>\r\nSee this <a href=\"https://www.youtube.com/watch?v=J5WS-0hrq3M\">You Tube link</a> of the Lewis Capaldi performance at Glastonbury shared via a fan.\r\n\r\n<strong>What is Tourette syndrome?</strong>\r\n\r\nNamed after 19th century researcher Gilles de la Tourette, Tourette syndrom is a neurological or neurodevelopmental condition.\r\n\r\nIt’s characterised by tics, which are involuntary movements or vocalisations.\r\n\r\nMany people have simple tics, especially children. But the official <a href=\"https://www.cdc.gov/ncbddd/tourette/diagnosis.html\">definition</a> of Tourette syndrome is motor and vocal tics nearly every day over more than 12 months.\r\n\r\nThere are two types of tics: motor tics and vocal tics.\r\n\r\nCommon motor tics often involve the head and neck. They can include things like:\r\n<ul>\r\n \t<li>eye blinking</li>\r\n \t<li>facial grimacing</li>\r\n \t<li>jerking the head and neck</li>\r\n \t<li>mouth movements</li>\r\n \t<li>shoulder jerks or jerking other parts of the body.</li>\r\n</ul>\r\nVocal tics can include:\r\n<ul>\r\n \t<li>throat clearing sounds</li>\r\n \t<li>humming sounds</li>\r\n \t<li>huffing or grunting</li>\r\n \t<li>sniffing</li>\r\n \t<li>high pitched squeals</li>\r\n \t<li>part of a word or syllable</li>\r\n \t<li>sometimes whole words or phrases.</li>\r\n</ul>\r\nSometimes in more severe cases of Tourette syndrome, people might have more complex tics and more orchestrated sequences of movements. This can include, for example, turning in a certain direction or tapping something a certain number of times. Often it’s a sequence that feels right for that person, which they have to complete to relieve tension.\r\n\r\n[caption id=\"attachment_1745237\" align=\"alignnone\" width=\"720\"]<img class=\"size-full wp-image-1745237\" src=\"https://www.dailymaverick.co.za/wp-content/uploads/2023/06/11557531.jpg\" alt=\"\" width=\"720\" height=\"436\" /> <em>Scottish singer-songwriter Lewis Capaldi performs on the Pyramid Stage at the Glastonbury Festival in Pilton, Britain, 24 June 2023. The Glastonbury Festival is a five-day festival of music, dance, theatre, comedy and performing arts running from 21 to 25 June 2023. EPA-EFE/ADAM VAUGHAN</em>[/caption]\r\n\r\nInitially there is what we call a “premonitory urge”. It’s like an itch or the feeling you get before you sneeze. There’s a build-up up of tension and it’s relieved by the expression of the tic.\r\n\r\nPeople are often able to recognise this feeling prior to the tic and that’s an important part of tic management.\r\n\r\nTics usually have onset in childhood, typically in the early primary school years, but occasionally later in life.\r\n\r\nTourette syndrome often runs a frustratingly waxing and waning course. There may be periods where it’s not noticed for weeks or even months and then it comes back.\r\n\r\nSometimes tics get worse in response to stress, like the start of a new school term or moving house. Sometimes they get worse for no reason at all.\r\n\r\nThere can be an element of suggestibility; talking about a tic can bring on that tic.\r\n\r\nThere’s also a degree of suppressibility. People with tics can either subconsciously or consciously suppress them. Kids often don’t have many tics at school because they know they might get teased, but after school the parent often sees a lot of tics come flowing out.\r\n\r\nPeople can often camouflage tics. For example, if they have an urge to jerk their arm, they may scratch their chin and transform it into something else. That’s often a part of treatment or a method their team may work with them on.\r\n\r\n<strong>How is it treated?</strong>\r\n\r\nOften we don’t need to do anything about Tourette syndrome because it’s not causing problems in terms of a person’s self-esteem or their broader life. They can still hold a pen or a spoon and it’s not affecting their day-to-day function.\r\n\r\nMost cases are not severe and the tics don’t need any intervention.\r\n\r\nBut many kids with Tourette syndrome also have other conditions such as ADHD, OCD and anxiety. So if the Tourette syndrome isn’t causing harm the paediatrician may be more concerned about treating those issues first.\r\n\r\nThe marker for Tourette syndrome needing treatment is whether it’s bothering the child.\r\n\r\nIf it is, we consider what we can do about the tics themselves. They are quite hard to treat.\r\n\r\nA psychologist will usually work on general anxiety management strategies, as anxiety can be a significant driver of tics.\r\n\r\nThere is also a treatment strategy known as <a href=\"https://www.cincinnatichildrens.org/health/t/tic-intervention#:%7E:text=CBIT%20is%20an%20established%20therapy,and%20worse%20on%20their%20own.\">comprehensive behavioural intervention for tics</a>, which is a dedicated program to help people manage their tics. But it can be difficult to access due to availability.\r\n\r\nThere are medications for severe cases but they’re not very effective at reducing tics and can cause side effects.\r\n\r\n<strong>Why do some people get Tourette syndrome?</strong>\r\n\r\nWe think Tourette is largely <a href=\"https://pubmed.ncbi.nlm.nih.gov/28150698/\">genetic</a>.\r\n\r\nIt’s nothing to do with anything the parents have done or the child has done, and it’s not caused by anything that happened during pregnancy.\r\n\r\nIt’s not one gene that causes it but rather a combination.\r\n\r\n<strong>Reducing stigma is key</strong>\r\n\r\nTourette syndrome is, by nature, a highly stigmatising condition because at the severe end people can do very unusual things and draw attention to themselves, through no fault of their own, which can cause embarrassment.\r\n\r\nOne thing we can do for kids, if they are able to, is suggest they go to their school with the support of a carer or parent and talk to classmates about their Tourette. They explain what it is and why they can’t help it. Often that can lead to more acceptance from other kids.\r\n\r\nMost people with Tourette syndrome can live normal lives.\r\n\r\nEducation is key to reducing stigma. The <a href=\"https://tourette.org.au/\">Tourette Syndrome Association of Australia</a> has some great information and resources. <strong>DM</strong><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines -->\r\n\r\n<a href=\"https://theconversation.com/profiles/daryl-efron-13585\">Daryl Efron</a>, Associate Professor, department of paediatrics, <em><a href=\"https://theconversation.com/institutions/the-university-of-melbourne-722\">The University of Melbourne</a></em>\r\n\r\nThis article is republished from <a href=\"https://theconversation.com\">The Conversation</a> under a Creative Commons license. Read the <a href=\"https://theconversation.com/what-is-tourette-syndrome-the-condition-lewis-capaldi-lives-with-200630\">original article</a>.",
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"summary": "You might have seen the news of fans of singer Lewis Capaldi helping him finish a song at the Glastonbury concert this week, after symptoms of his Tourette syndrome suddenly flared up and temporarily prevented him from performing. So, what is Tourette syndrome and how is it managed? Here’s what you need to know.",
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