Tourette syndrome, a condition of the nervous system, causes sudden, repetitive and uncontrollable behaviors. These behaviors include everything from words and sounds to simple movements, known cumulatively as “tics.”

This condition tends to develop between ages 2 and 15, and there is no known cure. However, there are treatment and support options that help patients with Tourette syndrome manage their symptoms.

Symptoms and Complications

The symptoms of Tourette syndrome are separated based on the nature of the tics involved: simple tics and complex tics. They’re also categorized as motor tics (involving movement) or vocal tics (involving sounds).

Common simple motor tics include:

  • • Head jerking
  • • Frequent eye blinking or darting
  • • Nose twitching
  • • Abnormal mouth movements
  • • Shoulder shrugging

Common simple vocal tics include:

  • • Grunting
  • • Coughing
  • • Clearing the throat
  • • Barking

Common complex motor tics include:

  • • Repeating similar movements over and over
  • • Obscene gestures
  • • Bending or twisting
  • • Touching or smelling objects repeatedly
  • • Hopping
  • • Stepping in particular patterns

Common complex vocal tics include:

  • • Repeating phrases, either your own or someone else’s
  • • Using vulgarity or swear words

Tics may change based on several factors, including stress and sleep levels or changes in age. In people with Tourette syndrome, tics are preceded by a sensation known as a premonitory urge—often itches or tingling feelings that are then relieved by the tic itself.

People with Tourette syndrome can still lead normal lives, but in some cases, other challenging conditions can result:

  • • Obsessive-compulsive disorder (OCD)
  • • Attention-deficit hyperactivity disorder (ADHD)
  • • Learning disabilities
  • • Sleep disorders
  • • Anxiety, depression or anger management issues
  • • Pain, such as headaches, mostly related to tics
  • • Autism spectrum disorder
Tourette syndrome risk

Risk Factors

There aren’t any known causes of Tourette syndrome, but doctors believe it’s caused by a combination of environmental and genetic factors. It may also relate to chemicals in the brain like dopamine and serotonin, which help regulate nerve impulses. The two major risk factors of Tourette syndrome are family history and gender—men are three or four times as likely to develop Tourette syndrome than women, and a family history of the disease also increases your risk.

Treatments

There is no cure for Tourette syndrome, but there are several treatments aimed at helping people with Tourette to live a normal life by controlling tics and other symptoms:

Medication:

Medications that help control tics include:

  • Dopamine blockers: Medications that block or reduce the amount of dopamine can help, though side effects may include weight gain, involuntary movements or extreme depression.
  • ADHD medications: Stimulants meant for ADHD patients can also help improve attention span and concentration for patients with Tourette syndrome, though in certain cases, they can actually make tics worse.
  • Antidepressants: Symptoms of depression or anxiety, or OCD, can be controlled by antidepressants in some cases.
  • Central adrenergic inhibitors: These are medications usually prescribed for high blood pressure, but can help control impulse symptoms and rage. They may have drowsy side effects.
  • Antiseizure medications: Certain patients with Tourette syndrome may respond well to a treatment normally meant for epilepsy.

Therapy:

  • Behavior therapy: Habit-reversal training can help patients manage tics and identify the urges that lead to them. Behavioral therapy also helps find ways to change movements and make Tourette syndrome more bearable.
  • Psychotherapy: This is mostly used for complications like ADHD or OCD, but can also help you cope with Tourette syndrome.
  • DBS: This involves a battery-operated device in the brain that electronically stimulates certain areas of movement control. It’s generally only used in severe cases.
Tourette syndrome behavior therapy

Support Systems

Because of the social pressure and anxiety people Tourette syndrome may feel, support from family and friends is vital. Tics often peak during teenage years, some of the most difficult periods of social development. If your child has Tourette syndrome, you can provide support in several ways:

  • • Reach out to family members of other people with Tourette syndrome for advice and information.
  • • Remember that tics often improve with age.
  • • Remind teachers and other adults of the condition, and advocate for proper educational conditions.
  • • Promote positive self-esteem by supporting their interests and encouraging friendships.
  • • For kids (or parents) who need it, find a support group in your area.

If you notice symptoms of Tourette syndrome in your child, speak with your doctor about non-invasive testing and your options moving forward.

Our neurologists are trained specialists and work with your primary care physicians to develop a treatment plan personalized for you. We have access to the latest in imaging technology and our specialists are up to date on the most recent treatment options.

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Sources:

“Tourette Syndrome.” WebMD. http://www.webmd.com/brain/tourettes-syndrome#1

“Tourette syndrome.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/tourette-syndrome/home/ovc-20163623

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