Tourette syndrome
Tics typically show up between ages 2 and 15, with the average being around 6 years of age. Males are about three to four times more likely than females to develop Tourette syndrome.
Although there's no cure for Tourette syndrome, treatments are available. Many people with Tourette syndrome don't need treatment when symptoms aren't troublesome. Tics often lessen or become controlled after the teen years.
Symptoms
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.
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.
Causes
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.
Risk factors
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.
Complications
People with Tourette syndrome often lead healthy, active lives. However, Tourette syndrome frequently involves behavioral and social challenges that can harm your self-image.
Conditions often associated with Tourette syndrome include:
- Attention deficit hyperactivity disorder (ADHD)
- Obsessive–compulsive disorder(OCD)
- Autism spectrum disorder
- Learning disabilities
- Sleep disorders
- Depression
- Anxiety disorders
- Pain related to tics, especially headache
- Anger-management problems
Diagnosis
There's no specific test that can diagnose Tourette syndrome. The diagnosis is based on the history of your signs and symptoms.
The criteria used to diagnose Tourette syndrome include:
- Both motor tics and vocal tics are present, although not necessarily at the same time
- Tics occur several times a day, nearly every day or intermittently, for more than a year
- Tics begin before age 18
- Tics aren't caused by medications, other substances or another medical condition
A diagnosis of Tourette syndrome might be overlooked because the signs can mimic other conditions. Eye blinking might be initially associated with vision problems, or sniffling attributed to allergies.
Both motor and vocal tics can be caused by conditions other than Tourette syndrome. To rule out other causes of tics, your doctor might recommend:
- Blood tests
- Imaging studies such as MRI
Treatment
There's no cure for Tourette syndrome. Treatment is aimed at controlling tics that interfere with everyday activities and functioning. When tics aren't severe, treatment might not be necessary.
- Medication
- Therapy
- Behavior therapy. Cognitive Behavioral Interventions for Tics, including habit-reversal training, can help you monitor tics, identify premonitory urges and learn to voluntarily move in a way that's incompatible with the tic.
- Psychotherapy. In addition to helping you cope with Tourette syndrome, psychotherapy can help with accompanying problems, such as ADHD, obsessions, depression or anxiety.
- DBS. For severe tics that don't respond to other treatment, DBS might help. DBS involves implanting a battery-operated medical device in the brain to deliver electrical stimulation to targeted areas that control movement.
