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Tourette Syndrome

(TS)

Definition

Tourette syndrome (TS) is a chronic disorder of the nervous system. It isa type of tic disorders. TS is known by its 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:

Causes

The 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.
Genetic Material
Chromosome DNA
TS is inherited through genes, which make up DNA.
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Risk Factors

Males are three to four times more likely to be affected. Other factors that may increase your risk of TS include:
  • Family history of TS
  • Having other tic disorders
  • Obsessive-compulsive disorder

Symptoms

Tics are the main symptoms of TS. To be TS, the tics must be:
  • Both motor and vocal tics
  • Be present for more than one year
  • Start before age 18
Tics range from mild-to-severe. They can occur suddenly and vary in the amount of time that they last. Tics may temporarily decrease with concentration or distraction. During times of stress, they may occur more often.
The tics are often increased with stress and tension. Concentration or distraction may decrease them. Tics are divided into motor and vocal. The following are some common examples:
  • 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
While tics may occur throughout life, butsymptoms may improve during later teens years.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.
Your doctor may order tests to rule out other medical conditions as the cause of the tics. Test may include MRI , CT scan, EEG,or blood tests.

Treatment

Talk with your doctor about the best treatment plan for you. Education and therapy are often parts of the treatment plan. In some cases, medicine may be needed.

Education and Therapy

Learning 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.
In addition, relaxation, biofeedback, and exercise can reduce help to reduce stress.

Medications

Medication is not required in most cases. No certain medication works in all people with TS. If a doctor prescribes medication, there are usually strong side effects.
Medications that may be prescribed include:
  • Antipsychotics—To help control tics
  • Certain antidepressants known as selective seratonin reuptake inhibitors (SSRIs)—To manage related obsessive-compulsive habits
  • Stimulants or medication used to treat high blood pressure—To manage symtoms related to ADD and ADHD

Prevention

There is no known way to prevent TS.

RESOURCES

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov

Tourette Syndrome Association http://www.tsa-usa.org

CANADIAN RESOURCES

About Kids Health http://www.aboutkidshealth.ca

Tourette Syndrome Foundation of Canada http://www.tourette.ca

References

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/what.php. Updated September 3, 2012. April 3, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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