Tourette’s syndrome is a neurological disorder that causes sudden, repeated movements and sounds called tics, which are involuntary.
What it is
Tourette syndrome is a neurological disorder involving at least two motor tics and one vocal tic for over a year, starting before age 18.
Cause
Not fully understood. It involves brain circuits (basal ganglia) and neurotransmitters like dopamine. It is often inherited.
Tics
Eye blinking, shoulder shrugs, throat clearing and sounds. They may wax and wane.
Prevalence
The CDC estimates about 1 in 162 children aged 6 to 17 have it, more in boys.
Treatment
Behavioral therapy (CBIT), medicines for severe tics.
Course
Tics often peak around age 10 to 12 and improve in adulthood.
Coprolalia
Swearing occurs in only about 10 percent.
Support
Tourette Association of America.
Statistics
The CDC says around 1 in 50 US children aged 6 to 17 has been diagnosed with Tourette syndrome, and it is about three times more common in boys than girls. Many cases are mild.
Diagnosis
Diagnosis requires multiple motor tics and at least one vocal tic present for more than a year, with onset before age 18. There is no single blood or imaging test. Doctors rule out other conditions.
Premonitory urge
Many people feel a build-up of tension or an urge before a tic, and a short relief after. This is why they can sometimes suppress tics for a time, but suppression takes effort.
Triggers
Stress, excitement, tiredness and anxiety can increase tics. Tics can lessen during focused activity, such as playing an instrument or sports.
Common conditions together
Tourette often occurs with ADHD, obsessive compulsive disorder, anxiety and learning difficulties. Treating these can improve quality of life.
Treatment options
- Comprehensive Behavioral Intervention for Tics (CBIT), a type of therapy that teaches awareness and competing responses.
- Medications such as alpha-2 agonists or antipsychotics for troublesome tics.
- Botulinum toxin injection for single severe tics.
- Deep brain stimulation in rare, severe adult cases.
Outlook
Tics usually peak around ages 10 to 12 and often improve in late teens and adulthood.
Prevalence and diagnosis in detail
Tourette syndrome affects roughly 1 in 162 US children aged 6 to 17, according to the CDC, and about 3 times as many boys as girls. Diagnosis requires at least two motor tics and one vocal tic present for more than a year, with onset before age 18, and no other cause such as medications. Tics usually begin between ages 5 and 7, are worst in the early teens and improve in adulthood for many people. Only about 10 to 15 percent of people with Tourette have coprolalia, the involuntary swearing seen in popular culture. Many people feel a premonitory urge, like an itch, before a tic, and relief after it.
Associated conditions and therapy
About 86 percent of children with Tourette have at least one other condition, most commonly ADHD, OCD, anxiety or learning difficulties, according to the CDC. Stress, excitement and fatigue can worsen tics. First line treatment is a behavioral approach called CBIT (Comprehensive Behavioral Intervention for Tics), which trains people to notice the urge and use a competing response, and studies show about 50 percent have clinically meaningful tic reduction. Medicines such as aripiprazole, risperidone and clonidine are used for tics that interfere with life, and deep brain stimulation is an option in severe adult cases. Tourette is not caused by parenting, and school accommodations can help.
Based on data from the CDC and the Tourette Association of America
