Tourette syndrome

Tourette (too-RET) syndrome is a nervous system (neurological) disorder that starts in childhood. It involves unusual repetitive movements or unwanted sounds that can't be controlled (tics). For instance, you may repeatedly blink your eyes, shrug your shoulders or jerk your head. In some cases, you might unintentionally blurt out offensive words.

Signs and symptoms of Tourette syndrome typically show up between ages 2 and 12, with the average being around 7 years of age. Males are about three to four times more likely than females to develop Tourette syndrome.

Although there's no cure, you can live a normal life span with Tourette syndrome, and many people with Tourette syndrome don't need treatment when symptoms aren't troublesome. Symptoms of Tourette syndrome often lessen or become quiet and controlled after the teen years.

Symptoms Causes Risk factors Complications

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

Tics are classified as either:

  • Simple tics, which are sudden, brief and repetitive, involving a limited number of muscle groups
  • Complex tics, which are distinct, coordinated patterns of movements that involve several muscle groups

Tics involving movement (motor tics) — often facial tics, such as blinking — usually begin before vocal tics do. But the spectrum of tics that people experience is diverse, and there's no typical case.

Common motor tics seen in Tourette syndrome
Simple ticsComplex tics
Eye blinking Touching the nose
Head jerking Touching other people
Shoulder shrugging Smelling objects
Eye darting Obscene gesturing
Finger flexing Flapping the arms
Sticking the tongue out Hopping
Common vocal tics seen in Tourette syndrome
Simple ticsComplex tics
Hiccuping Using different tones of voice
Yelling Repeating one's own words or phrases
Throat clearing Repeating others' words or phrases
Barking Using vulgar, obscene or swear words

In addition, if you have Tourette syndrome, your tics may:

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

Before the onset of motor or vocal tics, you'll likely experience an urge called a premonitory urge. A premonitory urge is an uncomfortable bodily sensation, 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 a tic or hold back tics until they find a place where it's less disruptive to express them.

When to see a doctor

If you notice your child displaying involuntary movements or sounds, schedule an appointment with your pediatrician. Not all tics indicate Tourette syndrome.

Many children develop tics lasting a few weeks or months that go away on their own. But whenever a child shows unusual behavior, it's important to have a medical evaluation to identify the cause and rule out serious health problems.

The exact cause of Tourette syndrome isn't known, and there's no known way to prevent it. Tourette is a complex syndrome, likely caused by a combination of genetic and environmental factors. Theories about the causes of Tourette include:

  • Genetics. Tourette syndrome may be an inherited disorder. The specific genes involved in Tourette syndrome are still being defined, although one genetic mutation has been identified as a rare cause of Tourette syndrome.
  • Brain abnormalities. Certain chemicals in the brain that transmit nerve impulses (neurotransmitters) may play a role, including dopamine and serotonin.

Risk factors for Tourette syndrome include:

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

People with Tourette syndrome have a normal life span and often lead healthy, active lives. However, having Tourette syndrome may increase your risk of learning, behavioral and social challenges, which can harm your self-image.

In addition, having Tourette syndrome means you're likely to have other related conditions, such as:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Obsessive-compulsive disorder (OCD)
  • Learning disabilities
  • Sleep disorders
  • Depression
  • Anxiety disorders
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