What is Tourette syndrome?

Tourette syndrome, or simply Tourette’s, is a complex nerve disorder that causes a person to make sudden, uncontrollable, repeated movements or vocal sounds called tics.

Tourette syndrome symptoms

The main symptoms of Tourette’s are tics, usually repeated, rapid body movements or vocalizations (sounds). Tics come and go and most are mild. They often change in location, type, frequency, and intensity ranging from mild to severe.

Tics usually begin between the ages of 5 and 10. Tic symptoms usually peak in intensity during early adolescence. Symptoms then typically become more easily controlled during late adolescence and early adulthood.

Tics may improve during periods of calm or focused activity and even go away completely during deep sleep. Tics can occur during light sleep.

Symptoms may worsen during periods of excitement, illness, stress, fatigue, or anxiety. Physical discomfort or hearing similar sounds to vocal tics may provoke tic symptoms.

Some people with Tourette syndrome can control tics to a certain extent. But tension often builds up to where a tic must be expressed involuntarily.

 

Types of tics that occur with Tourette’s

Tics are classified based on whether they involve muscles (motor tics) or sounds (vocal tics).

They are then further classified into simple or complex tics.

  • Simple tics are sudden, quick, repetitive movements in just a few muscles. Simple tics occur more frequently than complex tics and may happen right before a complex tic.
  • Complex tics involve several muscle groups that perform distinct, coordinated movement patterns.

Simple motor tics may include:

  • Eye blinking
  • Eye darting
  • Facial grimacing/nose scrunching
  • Head or shoulder twitching
  • Jaw or mouth movements
  • Nose twitching
  • Shoulder shrugging

Simple vocal tics may include:

  • Barking
  • Coughing
  • Grunting
  • Shouting
  • Sniffing
  • Throat clearing

Complex motor tics may include:

  • Bending
  • Gesturing
  • Hopping
  • Jumping
  • Sniffing or touching an object
  • Stepping in a certain pattern
  • Twisting

Complex vocal tics may include:

  • Repeating words or phrases
  • Repeating another person’s words or phrases (echolalia)
  • Using vulgar, obscene, or swear words (coprolalia)

Causes of Tourette syndrome

Scientists believe that chemical messengers (neurotransmitters) in the brain, such as dopamine, norepinephrine, and serotonin, are not able to properly communicate between nerve cells in people with Tourette’s. 

Experts don’t know exactly why this happens. The condition does run in some families, and researchers have found associations between Tourette syndrome and changes (mutations) in specific genes in a very small number of people. But most people with Tourette syndrome have no relatives with the condition. 

Tourette syndrome diagnosis

There is no specific test for Tourette syndrome. Diagnosing this condition can be challenging because some tics may overlap with symptoms of other conditions. For example, sniffling may be a symptom of allergies or eye blinking may result from an eye or vision problem. 

Doctors use a list of criteria to diagnose Tourette’s: 

  • Presence of both motor and verbal tics 
  • The onset of tic symptoms before the age of 18 
  • Tics happen multiple times a day, every day, or on and off for more than one year 
  • There are no other explanations for the tics, such as medications or other conditions or substances 

Blood tests and certain imaging studies, such as computed tomography (CT) scans, electroencephalography (EEG), or magnetic resonance imaging (MRI), can rule out other conditions that may cause symptoms that mimic Tourette syndrome. 

 Tourette syndrome treatment 

There is no cure for Tourette syndrome, but treatments may help control tics. Mild tics may not require treatment, while more severe tics or tics that cause accidental self-harm may need to be controlled with medication.

Care for Tourette syndrome at Penn Medicine

As the leading movement disorders center in the Philadelphia region, Penn Medicine’s Movement Disorders Center has decades of experience caring for adults with Tourette syndrome. Our involvement in research and clinical trials puts us at the leading edge of Tourette syndrome treatment, so we can offer every available therapy. We work with you to understand your symptoms and needs and create a treatment plan that brings you the most relief.

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