Review of current Tourettes treatments that may be available for Le Roy girls


Quote…”The best treatment of Tourette’s symptoms out of the methods described – between antipsychotic medications, behavioral remedies, and simply letting time take its toll – is perhaps the behavioral method. As in Susan’s case, the symptoms were drastically reduced within the length of the experiment. Those who use this method will not have to deal with recurring and costly medication fees and also would not have to deal with the side-effects involved in taking medication. By learning to suppress tics, one can maintain a more long-term effect of tic reduction. Behavioral methods such as response prevention, therefore, may be the best option for Tourette’s patients.  …

habit reversal, appears to be a good alternative for Tourette’s patients who do not wish to use medicinal treatments due to the side-effects or other reasons. Response prevention has been shown to have about the same high level of efficacy as habit reversal (Phelps, 2008).

The final method of treatment, as of now, is simply time. A significant reduction in tics occurs naturally by the age of 19 or 20, and one affected by Tourette’s could choose to wait for that (Phelps, 2008). Of course, waiting for the tics to recede naturally is not guaranteed; Tourette’s-afflicted adults still tic although often to a lesser degree. Going without treatment may not be the best option, however. Those who have Tourette’s experience the worst of the symptoms during their childhood and adolescence. The social consequences of freely exhibiting tics often include teasing, bullying, and estrangement, as seen in the case study examined. The psychological impact on the child may have very negative effects for self-esteem, especially during school age years when the child’s peers are more prone to making hurtful comments,

The best treatment of Tourette’s symptoms out of the methods described – between antipsychotic medications, behavioral remedies, and simply letting time take its toll – is perhaps the behavioral method.”

…unquote

This quote is from this article by a researcher who summarized the then current view on Tourettes therapy. It is a well-written, thoughtfully researched article by a scholar who truly cares about the plight of Tourettes patients in a community of peers who find it difficult to accept anybody different. Exhibiting Tics in a society setting is treated as an embarrassment.

The abstract of the article by a researcher in Psychology Kathy Chen, follows below. She has listed relevant references from 1980 until 2009.
Tourette’s Syndrome
Abstract
This paper describes of the symptoms of Gilles de la Tourette’s Syndrome and the treatment
options available for those who have this disorder. One case study of a man with Tourette’s is examined, which provides information about the disorder’s effect on his social interactions with others as well as his explanations for the irresistible tics he experiences. The three main types of treatment methods – medicinal, behavioral, and the natural reduction of symptoms with time – are discussed. Then, a specific experiment which describes a girl named Susan and her successful treatment with a behavioral remedy is discussed.

Kathy Chen has summarized current choices in Tourettes therapy in her article and explains why behavioral therapy may prove to be most beneficial. Now, how does current research in Tourettes syndrome assist the 12 girls in Le Roy High school exhibiting similar symptoms?

Tourettes and Public Health
As a society, we have failed to stop the rising trend of Tic exhibiting diseases. While the Tourettes name was given to a diagnosis in 1884, the sudden rise in Tourettes like symptoms since 1980s has been largely ignored by citizens. Parents of patients have had to resort to forming their own communities and locate physicians willing to research this rising phenomenon. Generally, Tourettes is found in young, school aged boys. It appears to improve by the age of 19, with Tics presenting sometimes under stressful situations.

12 girls with Tourettes like syndrome at Le Roy High School
This makes the situation at Le Roy High School with 12 girls, all of them 17 years of age, presenting with the symptoms an unusual situation. That is why is heartening to learn that the National Institute of Health (NIH), Bethesda, Maryland has offered to treat these girls free of charge. Their unusual case requires not only personalized treatment but also extensive, collaborative, multi-pronged research into why 12 girls and not boys showed Tourettes like symptoms. Some factors the girls may have shared:

1) Everybody knows how stressful the final years of school can be, especially when grades and sports become equally important for college applications. Those applications begin in september and are mostly done by December. The girls began showing symptoms in september. Stress was a common factor.

2) Did  all the girls have the gardasil vaccine?

3) Did all these girls have a strep throat infection?

4) Did all these girls get exposed to the same lawn herbicide just before a game?

5) Did all these girls have the same snack with a long list of ingredients perhaps before a game or from the same snack machine? Perhaps, an energy drink? Perhaps, a crunchy snack?

6) Are all these girls bulimic perhaps, and share a mineral imbalance from binging and throwing up?

7) Do all these girls have a member in their family with multiple sclerosis, autism, or dyslexia?

The researchers are going to look into what else the girls had in common. What factors did they share that caused only them to exhibit symptoms? All 17 year olds in that school were exposed to similar levels of stress, similar environment in school grounds and lived within a few miles of each other and so the same community environment.

Erin Brokovich’s inquiry into Le Roy Tourettes cases
The train derailment in 1970 close to that community was brought to light by environmental crusader Erin Brokovich and her research team. It was one of the worst chemical spills in the state of New York resulting in a superfund clean up site, one of several in the nation. Her team wants answers to two primary questions:
1) Is it a temporary occurrence in the environment?
2) Temporary occurrence from some sort of biological event (not ruling out the role of environment)?

Genetics and its role in Le Roy Tourettes cases
Tourettes patients have shown to have genetics connecting them to some members of their family, especially some twins, showing similar symptoms. While there is a supposedly genetic connection, no single gene or set of genes stands out. This is therefore, a complex research scenario when in Tourettes cases in Le Roy all were 17 year old girls, within the same environment, with no obvious genetic history to the Tourettes symptoms. How then are the researchers to proceed?

Naturally, a multi-pronged research study will be the choice. One cannot rule out any factor the girls may have shared until proved otherwise. Then, the role of stress genes and how they might interplay with the genes triggered by the said common factor/s identified.

The Le Roy High School girls are fortunate that NIH researchers will now examine their unusual case from every possible angle. NIH has some of the finest researchers in this field. All along, dedicated Physicians will attempt to treat the symptoms with no knowledge of what may have caused the Tourettes-like symptoms to appear in the first place. Naturally, they will try the behavior treatment detailed above by Kathy Chen, which has proven beneficial in the past. This will have the least or no adverse affect. They might also prescribe clinical drugs, but these may have adverse effects. Considering that such symptoms ease by the age of 19, the physicians will have to balance their choices. Should they wait for these girls to show improvement around age 19? Tourettes has mostly been observed until recently in boys and hence studied in boys. Would it also follow a similar course in girls?

Do you see Tourettes-like cases in your community rising?
Do your grandparents observe that such cases like Tourettes and Autism were never seen in their communities?
Do your parents observe that Tourettes and Autism were never seen in such large numbers in their classrooms?
In recent years, does your school district have rising numbers of children with Tourettes, Autism, Leukemia and Juvenile rheumatoid arthritis?
If yes, have you ever wondered why? If yes, have you begun to ask questions?

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