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Tourette Syndrome

Definition

Tourette syndrome (TS) is a chronic disorder of the nervous system. It is a type of tic disorder, with motor and vocal tics. These tics are rapid, involuntary movements or sounds that occur repeatedly.

Many people with TS also have one or more of the following problems:

Causes

The exact cause of TS is unknown. However, brain chemicals, called dopamine and serotonin are most likely involved.

There may be a genetic link to TS, although some have no known family history.

Genetic Material
Chromosome DNA
TS is inherited through genes, which make up DNA.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Males are three to four times more likely to be affected. Other factors that may increase your risk of TS include:

  • Family history of TS
  • Having other tic disorders
  • Obsessive-compulsive disorder
  • Maternal stress during pregnancy
  • Daily use of coffee, cigarettes and alcohol by the mother before pregnancy

Symptoms

Tics are the main symptoms of TS. To be TS, the tics must be involuntary and:

  • Both motor and vocal tics
  • Be present for more than one year
  • Start before age 18
  • Not absent at any time for > 3 months
  • Not be due to a physiological cause like substances or a medical condition

Tics will usually happen daily, range from mild-to-severe and change in type over time. They can occur suddenly and vary in the amount of time that they last. Tics may temporarily decrease with concentration or distraction. During times of stress and tension, they may occur more often.

Tics are divided into motor and vocal. The following are some common examples:

  • Motor tics
    • Simple—eye blinking, head jerking, arm or shoulder shrugging
    • Complex—jumping, smelling, touching things or other people, twirling around
  • Vocal tics
    • Simple—throat clearing, coughing, sniffing, grunting, yelping, barking
    • Complex—saying words or phrases that do not make sense in a given situation, saying obscene or socially unacceptable words—called coprolalia

While tics may occur throughout life, but symptoms may improve during later teens years.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

The diagnosis of TS is usually made by the symptoms alone. Your doctor may order tests to rule out other medical conditions as the cause of the tics.

Treatment

Talk with your doctor about the best treatment plan for you. Education and therapy are usually parts of the treatment plan. In some cases, medicine may be needed.

Education and Therapy

Learning about TS is a very important part of treatment. Education can also be helpful for your family, friends, and coworkers.

Therapy can also help you develop habits to help manage tics or other related symptoms. Types of therapy include:

  • Behavior therapy can help people with TS learn to substitute their tics with other movements or sounds that are more acceptable.
  • Cognitive behavioral therapy can help reduce obsessive-compulsive symptoms.
  • Psychotherapy can help people with TS and their families cope with the disorder.

In addition, relaxation, biofeedback, and exercise can reduce help to reduce stress.

Medications

Medication is not required in most cases. No medication works in all people with TS. If a doctor prescribes medication, there are usually strong side effects.

Medications that may be prescribed include:

  • Clonidine—usually the first medication tried to control tics, but may not be effective
  • Antipsychotics—To help control tics
  • Certain antidepressants known as selective seratonin reuptake inhibitors (SSRIs)—To manage related obsessive-compulsive habits
  • Stimulants or medication used to treat high blood pressure—To manage symtoms related to ADD and ADHD

Prevention

There is no known way to prevent TS.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 03/2014 -
  • Update Date: 00/50/2014 -
  • National Institute of Neurological Disorders and Stroke

    http://www.ninds.nih.gov

  • Tourette Syndrome Association

    http://www.tsa-usa.org

  • About Kids Health

    http://www.aboutkidshealth.ca

  • Tourette Syndrome Foundation of Canada

    http://www.tourette.ca

  • NINDS tourette syndrome information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tourette/tourette.htm. Updated October 19, 2012. Accessed April 3, 2013.

  • Tourette syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 3, 2012. April 3, 2013.


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