DefinitionTourette 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:
- Compulsions and ritualistic behaviors
- Attention deficit disorder with or without hyperactivity (ADD or ADHD)
- Learning disabilities
- Difficulties with impulse control
- Sleep disorders
CausesThe 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.
|TS is inherited through genes, which make up DNA.|
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Risk FactorsMales are 3-4 times more likely to be affected. Other factors that may increase your chance 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
SymptomsTics 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 1 year
- Start before age 18
- Not absent at any time for more than 3 months
- Not be due to a physiological cause like substances or a medical condition
- 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
DiagnosisThe 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.
TreatmentTalk with your doctor about the best treatment plan for you. Education and therapy are usually parts of the treatment plan. In some cases, medications may be needed.
Education and TherapyLearning 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.
MedicationsMedication 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
- Antidepressants—to manage related obsessive-compulsive habits
- Stimulants or medication used to treat high blood pressure—to manage symtoms related to ADD and ADHD
PreventionThere are no current guidelines to prevent TS.
National Institute of Neurological Disorders and Stroke
Tourette Syndrome Association
About Kids Health—The Hospital for Sick Children
Tourette Syndrome Foundation of Canada
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.
- Reviewer: Rimas Lukas, MD
- Review Date: 01/2015
- Update Date: 05/06/2014
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