Tourette syndrome
Tourette syndrome"My son has TS plus. He was in position 2 weeks b/4 his
birth but during this time I was terribly
upset and my son turned out of position. I was unable to deliver him
breech and had to have a c-section. It was almost like he did the opposite of
what he should have right from the start when under stress."
"I was 'induced' for 3 days before they had to do an emergency c-section. I wonder to this day what that "pitocin" to induce birth could have done to his neurons in his brain"
"My daughter came on schedule, but was a breech birth. Labor was long and she was in distress, with periods of oxygen deprivation. Eventually she was delivered by forceps. I'd be willing to bet that her Tourette syndrome was triggered by that."
Three quotes from three mothers and many off the record conversations have pointed me toward a startling conclusion. It has always been known that Tourette syndrome is caused by a combination of environmental and genetic factors (nature vs. nurture). The Nature side of things is thoroughly covered on this site, the Nurture not so much. The only way I can defend this lapse is that environmental effects are so much harder to prove than genetic ones. But it seems birth difficulties could be a very strong "nurture" trigger.
It's hard to say why this may be. In all of the cases I've heard about, the baby is under a lot of stress. Caesarian sections, breech position and oxygen deprivation are all very stressful to an infant that is also attempting to learn to breathe and cope with light and cold. We all know that stress aggravates tics, but during this crucial time in an individual's life it seems to permanently aggravate them. As usual I have a theory, but it's a lot more dodgy than most of my other ones...take it with a large grain of salt.
The human brain sets its "normal" levels of hormones quite
young (I would imagine). If this is the case, then a period of prolonged
stress around the time of this normalisation could cause permanent changes.
Now it would make sense that when a child is born its brain has to learn to cope
with a large amount of new stuff. As I mentioned before; light, cold, loud
noise, having to breathe all have to be coped with in the first few seconds.
So it does make sense that many vital brain functions would be developed then.
Now, we know that medications can "burn out" the brain as it tries to cope with
elevated levels of one drug by shutting its receptors to that drug. This
means that less gets through. With the large amounts of norepinephrine
(stress hormone) released during a difficult birth this means that the levels of
dopamine (made from norepinephrine) will also increase. So the brain may
"burn out" on dopamine and shut down its receptors.
"Now hang on!" I hear you say "Touretters have more receptors than normal not less!"
That's true. Those with a genetic predisposition to TS will have more dopamine receptors. This means the large level or dopamine during a stressful birth and many more receptors will cause a huge physical reaction, probably with the baby going into shock. In order to recover, the body would slam shut the dopamine receptors and increase the amount of chemical in the brain which breaks down the dopamine.
This would take the child to a below average level of dopamine getting through in the brain. But it wouldn't be permanent. As the years go by, the brain will return to the equilibrium it had before birth by growing more dopamine receptors! When other body functions, like growth, happen the chemical balance changes and the dopamine channels reopen. This means that not only do they have more dopamine receptors than normal, but they are used to having less than normal!
This may explain why some people grow out of TS, as their brain learns to cope with increased dopamine, and the tics "disappear".
One study involving 16 pairs of monozygotic twins showed that low birth weight was a strong predictor of more severe tics (Hyde et al., 1992).