Overview

Tourette syndrome is a disorder characterized by repetitive, uncontrollable movements or sounds known as tics. These tics can include blinking, shoulder shrugging, or vocalizing unusual or offensive words. The condition typically appears between ages 2 and 15, with males being more likely to develop Tourette syndrome than females. While there is no cure for the disorder, treatments are available, and symptoms often improve after the teenage years.

Symptoms

Tics are the main symptom of Tourette syndrome, and they can range from mild to severe. Tics are categorized as simple or complex, based on the number of muscle groups involved. They can involve either motor movements or vocalizations. Common motor tics include eye blinking, head jerking, and shoulder shrugging. Common vocal tics include grunting, coughing, and throat clearing. Tics can vary in type, frequency, and severity, and they may worsen under certain conditions, such as stress or illness.

Prior to the onset of tics, individuals with Tourette syndrome often experience premonitory urges, such as itching, tingling, or tension. Expression of the tic provides relief, and some individuals can temporarily suppress or hold back their tics with great effort.

When to See a Doctor

If you notice your child displaying involuntary movements or sounds, it’s essential to see a pediatrician for evaluation. Not all tics indicate Tourette syndrome, as many children develop tics that go away on their own. However, it’s crucial to identify the cause and rule out any serious health problems.

Causes

The exact cause of Tourette syndrome is not known. It is believed to result from a combination of genetic and environmental factors. Chemicals in the brain that transmit nerve impulses, such as dopamine and serotonin, may play a role in the development of the disorder.

Risk Factors

Family history of Tourette syndrome or other tic disorders is a significant risk factor for developing the condition. Additionally, males are more likely than females to develop Tourette syndrome.

Complications

While people with Tourette syndrome can lead healthy lives, the condition often presents behavioral and social challenges that can impact self-image. Tourette syndrome is frequently associated with other conditions, including attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), autism spectrum disorder, learning disabilities, sleep disorders, depression, anxiety disorders, and anger-management problems. Some individuals may also experience pain related to tics, particularly headaches.

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Diagnosis

There is no specific test to diagnose Tourette syndrome. The diagnosis is based on the history of signs and symptoms. The criteria used for diagnosis include the presence of both motor and vocal tics, occurring several times a day for more than a year, starting before age 18, not being caused by other factors, and tics changing over time in various aspects. A diagnosis of Tourette syndrome might be overlooked initially as the signs can mimic other conditions, such as vision problems or allergies. Blood tests and imaging studies may be recommended to rule out other causes of tics.

Treatment

There is no cure for Tourette syndrome, but treatment aims to control tics that interfere with daily activities and functioning. When tics are not severe, treatment may not be necessary. Medications can be used to help control tics or reduce symptoms of related conditions. These may include medications that block or lessen dopamine, botulinum injections, ADHD medications, central adrenergic inhibitors, antidepressants, and antiseizure medications. Behavior therapy, such as Cognitive Behavioral Interventions for Tics, can help monitor tics and learn voluntary movements that are incompatible with the tic. Psychotherapy can also help cope with Tourette syndrome and associated problems. Deep brain stimulation (DBS) is a potential option for severe tics that do not respond to other treatments but requires further research.

Coping and Support

Tourette syndrome can impact self-esteem and social activities. Coping strategies include remembering that tics often peak in the early teens and improve with age, reaching out to others with Tourette syndrome for support and information. For children with Tourette syndrome, school may pose special challenges, and parents can be advocates for their child’s educational needs. Nurturing self-esteem and finding local support groups can also be helpful.

Preparing for Your Appointment

If you or your child has been diagnosed with Tourette syndrome, you may be referred to specialists such as neurologists, psychiatrists, or psychologists. To prepare for your appointment, be aware of any pre-appointment restrictions, write down symptoms and key personal information, make a list of all medications being taken, and consider making a video recording of a typical tic to show the doctor. Prepare questions to ask your doctor, such as the recommended treatment and options for medication or behavior therapy.

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