Tics / Tourette Syndrome
How Upper Cervical Care Relates to
Tics / Tourette Syndrome
Tic disorders are characterized by sudden, rapid movements (motor tics) or sounds (vocal tics) that are repeated over and over in a consistent way many times a day.
Tourette Syndrome (TS) is a debilitating tic disorder characterized by both motor and vocal tics. Diagnostic criteria include onset before the age of 21; recurrent, involuntary, rapid, purposeless motor movements affecting multiple muscle groups; one or more vocal tics; variations in the intensity of the symptoms over weeks to months; and a duration of more than one year.
Tourette Syndrome sufferers commonly experience other behavioral and neurological complaints such as attention deficits, depression, self-injurious behaviors, obsessive-compulsive behaviors, and irritability. These neurological symptoms are thought to be due to the same central nervous system (brain and spinal cord) malfunction that causes TS: alterations of dopamine and serotonin levels in the brainstem.
While researchers generally consider TS to be a genetic disorder (TS vulnerability is transmitted from one generation to the next), approximately 15% of TS patients do not show genetic susceptibility (no genetic links were found).1 In addition, individual variations in character, course, and degree of severity of TS cannot be explained by genetic hypotheses alone. Consequently, researchers have focused upon stressful events during perinatal or early life that may trigger the onset of TS.1 Traumatic head injury (during birth, falls, accidents, etc.) has been implicated as a possible trigger of TS.1 Evidence supports that trauma (in particular mild concussive injury to the head, neck or upper back) increases the risk of TS onset.2-13 Following the trauma, tics can be triggered immediately or can take months or years to develop.
The purpose of upper cervical care is to reverse the trauma-induced upper neck injury; thereby reducing irritation to the injured nerves in the central nervous system. While many TS sufferers recall specific traumas such as head injuries, birth trauma, auto accidents or falls, some do not. An evaluation is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from upper cervical care can be achieved.
Research Articles and Publications
- "Whiplash: Information For Drivers, Pedestrians, and Athletes" by Erin Elster, DC. The Atlas Files. June 2000.
- "Healthy and Well-Adjusted" By Cindy Schumacher, Maui Weekly, December 2013
- "Get Your Head On Straight" By Erin Elster, DC, Lahaina News, March 31, 2016
- Bruun RD, Cohen D, Leckman J. Guide to the diagnosis and treatment of Tourette Syndrome. www.mentalhealth.com. Bayside, New York: Tourette Syndrome Association. 1995-98.
- Keefover RW, Privite J. Adult-onset tourettism following closed head injury. J Neuropsychiatry Clin Neurosci 1989 Fall; 1(4): 448-9.
- Alegre S, Chacon J, Redondo L. Post-traumatic tics. Rev Neurol 1996 Oct; 24 (134): 1280-2.
- Beis JM, Andre JM, Paysant J. Motor and vocal tic after severe head trauma. Rev Neurol 2000 Mar; 156(3): 289-90.
- Gaul JJ. Posttraumatic tic disorder. Mov Disord 1994 Jan; 9(1): 121.
- Adeloye A, Kouka N. Gilles de la Tourette's syndrome associated with head injury: a case report. J Natl Med Assoc 1991 Nov; 83(11): 1018-20.
- Singer C, Snachez-Ramos J, Weiner WJ. A case of post-traumatic tic disorder. Mov Disord 1989; 4(4): 342-4.
- Fahn S. A case of post-traumatic tic syndrome. Adv Neurol 1982; 35: 349-50.
- Krauss JK, Jankovic J. Tics secondary to craniocerebral trauma. Mov Disord 1997 Sep; 12(5): 776-82.
- Seimers E, Pascuzzi R. Posttraumatic tic disorder. Mov Disord 1989; 4(4): 342-4.
- Chouinard S, Ford B. Adult onset tic disorders. J Neurol Neurosurg Psychiatry 2000 Jun; 68 (6): 738-43.
- Tijssen MA, Brown P, Morris HR, Lees A. Late onset startle induced tics. J Neurol Neurosurg Psychiatry 1999 Dec; 67(6): 782-4.
- Factor SA, Molho ES. Adult-onset tics associated with peripheral injury. Mov Disord 1997 Nov; 12(6): 1052-5.