22nd Nov 2022
Tourette syndrome is a neurological tic disorder whose hallmark symptom is tics. Tics come in different forms (e.g., repetitive movements, repeating one’s words) and are very difficult to control. Even when people with Tourette syndrome can control a tic, it’s only for a short while. Eventually, the tic has to occur.
Common tics include shoulder shrugging, eye blinking, throat clearing, and echolalia - repeating what other people have just said. These tics are in response to what’s called a premonitory urge, or a physical sensation like a tingling or an itch. Expressing the tic relieves these sensations.
Symptoms of tourette’s begin in childhood; there are various early indicators of tourette's that a parent can keep track of if they are concerned their child has the disorder. If someone develops tics for the first time as an adult, it will not be due to tourette’s.
As noted above, the primary symptom of Tourette’s disorder is tics. These tics fall into one of two categories: motor and vocal. In both cases, the tics might be simple or complex.
Simple tics involve a limited number of movements or actions. Good examples of a simple tic are eye blinking and throat clearing. These types of tics are sudden, repetitive, and brief.
Complex tics involve coordinated patterns of movement across multiple muscle groups. An example of this might be tilting one’s head to the left while hopping up and down.
A complex vocal tic is much more involved. These tics include repeating words or phrases, repeating what others have just said (echolalia), and in rare cases, coprolalia. This is a condition in which a person uses inappropriate or vulgar language.
Other complex motor tics manifest as hopping, jumping, or twisting, arm flapping, kicking, or stomping.
The symptoms of Tourette syndrome usually appear between the ages of 5 and 10. Motor tics in the head and neck area are most common at this age. Common triggers include anxiety, stress, or excitement. Periods of calm or focus on an activity tend to reduce the manifestation of tics.
Simple tics often precede complex tics, though, as time goes by, people with Tourette’s disorder experience different tics. The frequency of tics also changes. Approximately one-third of children with Tourette’s disorder have no tics by the time they enter adulthood.
Tourette’s symptoms commonly associated with the disorder in popular culture - echolalia and coprolalia - are rare. Neither symptom is necessary for a Tourette syndrome diagnosis.
Other conditions often accompany tourette’s symptoms or conditions. Behavioral, mental, and developmental disorders are most common and include:
Additionally, some people with Tourette syndrome exhibit social deficits. This typically manifests as a lack of social bonds and an inability to maintain social relationships.
The specific cause of Tourette’s disorder isn’t particularly well understood. However, modern research shows that genetics is part of the equation and that chemical imbalances in the brain might also be a factor.
Studies reveal that Tourette syndrome is likely a dominant gene, with roughly a 50% chance of the gene passing from one generation to the next. Boys with this gene are about three to four times as likely as girls to develop the disorder.
Additionally, researchers believe that the development of Tourette’s might be related to the breakdown of dopamine in the brain, or that dysfunction of dopamine transmission might be the cause. Issues with this breakdown/poor transmission leads to a buildup of dopamine; this is believed to contribute to tourette’s in some people.
Genetic factors and dopamine abnormalities don’t explain the development of Tourette syndrome in every patient, though. Approximately one in 20 children develop the disorder due to one of several potential risk factors, including: 
Other risk factors include a family history of the disease, infection, and poor physical health. Extreme stress and poor emotional health might also be risk factors.
Diagnosis of Tourette syndrome begins with a physical examination and a mental health evaluation.
A physical examination helps rule out other conditions that might cause Tourette-like symptoms (e.g., allergies that cause frequent eye blinking). Likewise, a doctor might order blood tests, neuroimaging (e.g., electroencephalogram (EEG), or magnetic resonance imaging (MRI)) to eliminate other potential causes of the symptoms.
A mental health evaluation serves much the same purpose. A mental health professional will explore the symptomatology and will typically ask questions like:
For a clinical diagnosis of Tourette syndrome, mental health professionals consult the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The DSM-V outlines the following criteria for diagnosing the disorder:
These diagnostic processes help doctors rule out various conditions. For example, a primary symptom of Huntington's disease is involuntary, jerky movements of the limbs, which might be mistaken for a Tourette syndrome tic. Other conditions often ruled out include seizures, postviral encephalitis, and overuse of medications.
There is no cure for Tourette syndrome, though most people with this disorder do not need treatment. However, if the symptoms are severe enough, treatment might take one of two courses: behavioral therapy or medication.
Medications are another option to help control tics. These include:
The preferred method of treating Tourette syndrome is behavioral therapy. Medications have varying efficacy from one person to the next. They also present a range of side effects that could make daily functioning more difficult than it already is. This being the case, medications are usually only prescribed if the tourette’s symptoms are severe.
As noted earlier, tourette’s symptoms often improve with age and treatment. However, there are many things you can do to improve your ability to cope with this disorder, starting with getting plenty of sleep and avoiding stressful situations.
Other self-care approaches include:
Above all, if you feel like you’re struggling to manage your Tourette’s, reach out to a mental health professional.
If you know someone with Tourette syndrome, one of the best things you can do is educate yourself about the disorder. Guides like this are a great start for being more informed about the nature of Tourette’s and its effects on people.
Other strategies you can use to help someone with Tourette syndrome include:
If your child has Tourette syndrome, there are additional things you can do to help them manage the disorder:
Tourette syndrome affects approximately one in 160 children in the United States. Worldwide, estimates are that Tourette syndrome affects one percent of the population. The disorder is more common in boys, who are also more likely to have chronic tics.
This disorder can have significant impacts on social and educational functioning during childhood. However, many people with Tourette syndrome grow out of their tics, which lessens the effects of the disorder on daily life. Those whose tics that remain into adulthood often see improvement with behavioral therapy, medication, or a combination of the two.