About tourette syndrome

What is tourette syndrome?

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.

The early symptoms of Tourette syndrome are almost always noticed first in childhood, with the average onset between the ages of 7 and 10 years. Tourette syndrome occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of Tourette syndrome, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

What are the symptoms for tourette syndrome?

Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified as:

  • Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
  • Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.

Tics also can involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.

Common motor tics seen in a person with Tourette Syndrome 

Simple tic 

  • eye blinking
  • head jerking
  • shoulder shrugging
  • eye darting

Complex tics

  • touching or smelling objects
  • repeating observed movements
  • stepping in a certain pattern
  • obscene gesturing
  • bending or twisting

Common vocal tics seen in people with Tourette Syndrome

Simple tic 

  • grunting
  • coughing
  • throat clearing
  • barking

Complex tics

  • repeating one's own words or phrases
  • repeating others' words or phrases
  • using vulgar, obscene or swear words

In addition, tics can:

  • Vary in type, frequency and severity
  • Worsen if you're ill, stressed, anxious, tired or excited
  • Occur during sleep
  • Change over time
  • Worsen in the early teenage years and improve during the transition into adulthood

Before the onset of motor or vocal tics, you'll likely experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. Expression of the tic brings relief. With great effort, some people with Tourette syndrome can temporarily stop or hold back a tic.

When to see a doctor

See your child's pediatrician if you notice your child displaying involuntary movements or sounds.

Not all tics indicate Tourette syndrome. Many children develop tics that go away on their own after a few weeks or months. But whenever a child shows unusual behavior, it's important to identify the cause and rule out serious health problems.

What are the causes for tourette syndrome?

The exact cause of Tourette syndrome isn't known. It's a complex disorder likely caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, might play a role.

What are the treatments for tourette syndrome?

If your tics aren’t severe and you experience a more mild form of Tourette syndrome, you may not need treatment. If your tics are severe or cause thoughts of self-harm, several treatments are available. Your healthcare professional may also recommend treatments if your tics worsen during adulthood.

Therapy

Your healthcare professional may recommend behavioral therapy or psychotherapy. This involves one-on-one counseling with a licensed mental health professional.

Behavioral therapy includes:

  • awareness training
  • competing response training
  • cognitive behavioral intervention for tics

Similar therapies can also be helpful for :

  • ADHD
  • OCD
  • anxiety

Your therapist may also use the following methods during psychotherapy sessions:

  • relaxation techniques
  • guided meditation
  • deep breathing exercises
  • hypnosis

You may find group therapy helpful. You’ll receive counseling with other people in the same age group who also have Tourette syndrome.

Medications

There are no medications that can cure Tourette syndrome.

However, your healthcare professional may prescribe one or more of the following drugs to help you manage your symptoms:

  • Haloperidol (Haldol), aripiprazole (Abilify), risperidone (Risperdal), or other neuroleptic drugs. These medications can help block or dampen dopamine receptors in your brain and help you manage your tics. Common side effects can include weight gain, movement problems, and mental fogginess.
  • Onabotulinum toxin A (Botox). Botox injections may help manage simple motor and vocal tics. This is an off-label use of onabotulinum toxin A.
  • Methylphenidate (Ritalin). Stimulant medications, such as Ritalin, can help reduce the symptoms of ADHD without increasing your tics.
  • Clonidine. Clonidine, a blood pressure medication, and other similar drugs can help reduce tics, manage rage attacks, and support impulse control. This is an off-label use of clonidine.
  • Topiramate (Topamax). Topiramate can be prescribed to reduce tics. Risks associated with this medication include cognitive and language problems, drowsiness, weight loss, and kidney stones.
  • Cannabis-based medications. There’s limited evidence that cannabinoid delta-9-tetrahydrocannabinol (dronabinol) may stop tics in adults. There is also limited evidence for certain strains of medical cannabis. Cannabis-based medications should not be given to children, adolescents, or people who are pregnant or nursing.

Neurological treatments

Deep brain stimulation is another form of treatment that’s available for people with severe tics. For people with Tourette syndrome, the effectiveness of this kind of treatment is still under investigation.

To undergo deep brain stimulation, your healthcare professional may implant a battery-operated device in your brain to stimulate parts that control movement. Alternatively, they may implant electrical wires in your brain to send electrical stimuli to those areas.

This method has been beneficial for people who have tics that have been deemed very difficult to treat. You should talk with your healthcare professional to learn about the potential risks and benefits for you and whether this treatment would work well for your healthcare needs.

What are the risk factors for tourette syndrome?

Risk factors for Tourette syndrome include:

  • Family history. Having a family history of Tourette syndrome or other tic disorders might increase the risk of developing Tourette syndrome.
  • Sex. Males are about three to four times more likely than females to develop Tourette syndrome.

Is there a cure/medications for tourette syndrome?

Like many people with Tourette syndrome, you may find that your tics improve in your late teens and early 20s. Your symptoms may even suddenly stop entirely in adulthood.

However, even if your Tourette symptoms decrease with age, you may continue to experience and need treatment for related conditions, such as depression, panic attacks, and anxiety.

It’s important to remember Tourette syndrome is a medical condition that doesn’t affect your intelligence or life expectancy.

With advances in treatment, your healthcare team, and access to support and resources, you can manage symptoms of Tourette, which can help you live a fulfilling life.

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