Some studies show that Tourette Syndrome affects one in 2,000-2,500 people. However, three times as many people will have some features, usually chronic motor tics or obsessive thoughts (Cramer, 1). Severe forms of Tourette Syndrome occur in approximately four or five of every 10,000 people. It is estimated that 2% of the general population and 200,000 Americans may suffer from the disorder (Bower, 151). Some investigators say that this statistic might even be slightly conservative because those with very mild tics may not seek medical attention. Because of the severity of some symptoms of Tourette's, this syndrome could possibly be the most debilitating of all tic disorders.

The symptoms of Tourette Syndrome can be classified as mild, moderate, or severe based on their frequency, complexity, and the degree to which they cause impairment or disruption of the patients' ongoing action and daily life. Although this disorder may impair a patient socially or physically, it does not impair thinking or intelligence.

Because there are several different types of tic disorders, patients exhibiting the symptoms previously mentioned must meet a certain criteria to be diagnosed with Tourette Syndrome. According to Dr. Phillip W. Long, the following criteria are used in diagnosing a person with Tourette's. Possible patients must exhibit both multiple motor and one or more vocal tics, although not necessarily simultaneously, for at least a one year period. They must also experience the occurrence of tics many times a day, usually in bouts, nearly every day, or intermittently throughout the span of more than one year. During this year, there should not have been a tic-free period of more than three consecutive months. There should also be periodic changes in the number, frequency, type and location of the tics, and in the degree of their severity. The disturbances must have caused marked distress or significant impairment in social, occupational, or other important areas of functioning.

Vocal tics may include loud grunting, moaning, or "barking" noises; repeated words, phrases, or sounds; noises that lack meaning; or repeated words or phrases that can be understood. Like motor tics, vocal tics are also identified in subcategories. Simple vocal tics are meaningless sounds and noises. They include clearing one's throat, coughing, grunting, barking, whistling, and repeating sounds. Complex motor tics are linguistically meaningful utterances such as words or phrases. These may include coprolalia (obscene or sexual language), echolalia (imitating what they just heard), and palilalia (imitating what they just said).

The main symptoms of Tourette Syndrome are motor, vocal, and mental tics, which tend to get better and worse in cycles. The most common initial symptom is a facial tic, and others follow. Contrary to popular belief, the tics associated with Tourette's are not completely involuntary. They are not spasms, but strong urges to make a certain motion or sound (Cramer, 1). The longer the urge to carry out an action is suppressed, the stronger the outburst becomes. Symptoms of the disorder generally do not appear until about 6 years of age (Burleigh 101).

Chloridine, a muscle relaxant often prescribed for high blood pressure, works well against motor tics, but not vocal tics. More than 50% of children with Tourette's who take Chloridine experience substantial long-term improvement in symptoms with minimal side effects. However, the benefits of Chloridine are often not seen until after 4-6 months of medication (Burleigh, 102

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