Tourette Syndrome

Tourette syndrome (TS) is a neurological disorder that affects your brain and nerves. It causes you to make sudden movements or sounds called tics. Tics are involuntary, so you can’t control or prevent them. Motor tics involve body movements, like eye blinking or shoulder shrugging. Vocal tics involve your voice, like sniffing or throat clearing. Motor tics tend to develop before vocal tics.

Tourette syndrome, or Tourette’s, usually starts in early childhood. Most of the time, tics become milder and occur less frequently in late adolescence and adulthood. Tourette syndrome is the most severe type of tic disorder.

Tourette syndrome affects 1 out of every 160 children, which means that approximately 300,000 children in the U.S. have the condition.

Symptoms of Tourette syndrome

The most common Tourette syndrome symptoms are motor and/or vocal tics. Tics usually start between the ages of 5 and 7 and peak around age 12.

Tics are either simple or complex:

• Simple tics: Simple tics are quick, repeated movements that only involve a few muscle groups. Shoulder shrugging and throat clearing are simple vocal tics.
• Complex tics: Complex tics involve many movements and muscle groups. Jumping and repeating certain words or phrases are complex vocal tics.

Tourette syndrome causes

Researchers don’t know the exact cause of Tourette syndrome. But the condition tends to run in families, so they believe genes may play a role. Issues with how your brain breaks down (metabolizes) neurotransmitters may also contribute to Tourette syndrome. Neurotransmitters, like dopamine, are chemicals in your brain that regulate behavior and movement.

Risk factors

Risk factors for Tourette syndrome may include:

• Sex: Males are 3 to 4 times more likely to develop Tourette syndrome.
• Biological family history: Parents may pass down Tourette syndrome to children through genes (inherited).
• Prenatal health: Children born to people who smoked or had health complications during pregnancy may be at a higher risk for Tourette syndrome. Low birth weight may also increase the chances of Tourette syndrome.

Does Tourette’s occur with other health conditions?

Most people with Tourette’s have other health conditions. These are usually mental or behavioral health disorders, including:

• Anxiety disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder (ASD)
• Depression
• Learning disabilities
• Obsessive-compulsive disorder (OCD)
• Oppositional defiant disorder (ODD)

How doctors diagnose Tourette syndrome

To diagnose Tourette syndrome, a provider checks when the tics started. They should begin before age 18. Your child must have both motor and vocal tics for over a year.

There isn’t a blood test or imaging exam that can detect Tourette syndrome. Instead, your child’s provider will carefully review their medical history and symptoms.

Their provider may also do tests to rule out other conditions that could be causing tics.

Tourette syndrome treatment

Mild tics that don’t affect your child’s everyday activities might not need treatment. But severe tics can make it hard to function at work, school or in social situations. Some tics can even lead to self-injury. In these cases, Tourette syndrome treatment, including medication or behavioral therapy, may help.

Tourette syndrome medication

For mild tics, your child’s healthcare provider may recommend medications that typically treat high blood pressure. These medications include clonidine and guanfacine.

For more severe tics, your child’s provider may recommend neuroleptics (antipsychotic medication). Neuroleptics are drugs that limit the activity of dopamine in your brain. Dopamine is a chemical that can increase tics.

Other medications can help manage conditions that occur with Tourette’s, like ADHD or OCD.

Tourette syndrome therapy

The tics associated with Tourette’s are involuntary, so they aren’t something you or your child can control. But new therapies help people manage tics and reduce their negative effects.

Comprehensive behavioral intervention for tics (CBIT) helps people:

• Recognize tics: Sometimes, people feel a sensation right before a tic occurs, called a premonitory urge. By recognizing this urge, they may be able to mask or suppress the tic.
• Respond to tics: Doing a new and different action when a tic occurs is a “competing response.” A voluntary action (shutting your eyes) limits the involuntary action (blinking).
• Reduce tics: Excitement or anxiety tends to make tics worse. Staying calm and avoiding stressful situations may reduce the frequency of tics.

When should I contact my healthcare provider about Tourette syndrome?

Contact a healthcare provider right away if someone with Tourette syndrome:

• Becomes violent
• Injures themselves
• Talks about suicide

You can call or text the Suicide and Crisis Lifeline at 988.

What is the outlook for someone living with Tourette syndrome?

There’s no cure for Tourette syndrome. The condition usually improves by early adulthood. Tics may still occur, but most adults don’t need to continue medication or therapy.

What is the life expectancy of someone with Tourette’s syndrome?

People with Tourette syndrome have a typical life expectancy. Tourette syndrome isn’t a progressive condition — it doesn’t get worse over time. In many cases, the condition is mild and the tics go away on their own.