Tourette's Syndrome

What Is It?

Tourette's syndrome is a neurological disorder (a problem with the nervous system), in which the major symptom is tics. Tics are sudden, brief, involuntary movements (motor tics) or sounds (vocal tics). In Tourette's syndrome, both types of tics are present.

Named after the French physician who first described it in the 19th century, Tourette's is believed to be an inherited condition that runs in families. It often is accompanied by other behavioral or emotional problems, for example, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, learning difficulties, sleep problems, depression, anxiety, and behavior problems.

Tics are relatively common, but Tourette's syndrome is less common. Tics occur in one out of 100 people, whereas the full Tourette's syndrome occurs in one of every 2,000. Boys are affected more often than girls.

Symptoms

Tics are involuntary and usually sudden, rapid, and repetitive. They appear in a variety of forms. No two people with Tourette's syndrome have the same symptoms.

Tics fluctuate over time. They become worse with anxiety, excitement, anger or fatigue, and can get better during absorbing activities or sleep. Some people with Tourette's describe an urge or warning sign before a tic. They may be able to suppress tics briefly.

Motor and vocal tics can be either simple or complex.

Simple motor tics involve just one muscle group, for example, an eye blink, a head jerk or a shoulder shrug. Complex motor tics use more muscles. The face or body may contort. The person may touch someone, sniff, jump, or make an obscene gesture. Sometimes a person will make a voluntary movement in order to cover up the tic, for example, a head thrust followed by smoothing the hair. Simple vocal tics include such sounds as grunting, barking, yelping and throat clearing. Complex vocal tics include syllables, words or phrases. During complex tics, a person with Tourette's may repeat his or her own words, repeat another person's words, or say obscene words or phrases.

Diagnosis

The most dramatic symptoms are easy to notice, but the disorder can be very hard to recognize. People with mild to moderate tics may be too embarrassed to discuss their problems. Parents and teachers usually pay more attention to behavior, learning and attention problems. Sometimes tics are mistaken for other medical problems. For example, people might consult an allergist for sniffling or an eye doctor for unusual eye movements.

The disorder is diagnosed by observing the tics. If they do not occur frequently enough for a doctor to notice them during a routine visit, a family member or friend needs to describe them. A videotape can be very helpful. Sometimes, to help define the problem, a doctor asks a family member to fill out a questionnaire.