Hello
C.M.
It is
true that, to be diagnosed with Tourette, you must have symptoms develop
before age 21 (actually, according to the newest criteria it is before
age 18). The reason for this criterion is because Tourette involves
a delayed (or stunted) maturation in particular parts of the brain --
as the individual grows and develops this delay becomes increasingly
apparent as other children are able to put the "brakes" on
various movements and noises better than (s)he can.
After
early adulthood is reached, the brain has more or less finished maturing.
If at that time a person is not experiencing tics, then those particular
areas of the brain involved in motor movements must have matured the
way they were supposed to.
This doesn't
mean, though, that a person can NEVER experience tics or involuntary
movements and noises after early adulthood is reached. What it DOES
mean is that these involuntary movements and noises have come about
for a different reason -- damage to those particular areas (for example
through head trauma or illness). Even though the symptoms may look the
same as Tourette on the surface, if they have a different cause (etiology)
a different diagnosis should be made.
It would
be important for you to review your childhood history carefully (perhaps
with parents and siblings as well) to ensure that you never had tic
symptoms when you were under age 18 -- if you did, then the diagnosis
of Tourette may then apply (i.e., perhaps your symptoms are mild enough
that they all but disappeared in adulthood, only to return now perhaps
as a result of increased situational stress or life transition).
I would
strongly urge that you continue to pursue this with your neurologist
or, if you are unsatisfied with his response, a new neurologist. If
the onset of these symptoms is NOT due to Tourette, it will be important
to identify the cause of them. From what you describe the condition
is becoming progressively more pronounced and may be a result of a condition
that requires detection and treatment.
I hope
this helps, and I wish you well in your exploration of this!
Dr. Dunc.
