Tourette Syndrome

This research paper explores Tourette Syndrome and its causes, symptoms, and treatments.

What is Tourette Syndrome?

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, who first described it in 1885. TS occurs in people of all ethnic groups; male children are affected about four times as often as females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit some milder version of the disorder.

Most children with TS display their first tics by age 7 or 8. Tics generally peak in severity during the early teenage years and then gradually subside during adulthood. However, some tics may persist into adulthood.

What Causes Tourette Syndrome?

The cause of TS is unknown. It appears to be inherited in many cases, but the exact mode of inheritance is not yet known. It is possible that TS results from a combination of genetic and environmental factors.

What Are the Symptoms of Tourette Syndrome?

Tics are the primary symptom of TS. Tics are classified as either motor or vocal. Motor tics are involuntary muscle movements, such as eye blinking, head jerking, or shoulder shrugging. Vocal tics are involuntarily sounds produced by moving air through the nose, mouth, or throat, such as grunting, sniffing, or throat-clearing.

Most people with TS have both types of tics. Tics can be further classified as simple or complex. Simple tics are isolated muscle groups that are briefly and repetitively engaged, such as eye blinking or nose twitching. Complex tics involve several muscle groups and are coordinated to produce specific patterns of movement, such as touching one's head then shoulders then hips in a specific sequence (known as a "touching tic").

Tics may vary in frequency, type, location, and severity over time. They often occur in bouts or "runs," lasting from minutes to hours, followed by periods of relative freedom from tics. Tics also tend to increase when the person is under stress, tired, or excited and decrease during periods of concentration, relaxation, or sleep.

In addition to tics, people with TS may also suffer from Obsessive-Compulsive Disorder (OCD). OCD is characterized by recurrent, persistent thoughts (obsessions) or repetitive behaviors (compulsions) that the person feels compelled to perform. The compulsions are usually performed in an attempt to relieve anxiety caused by the obsessions. People with TS often have OCD symptoms such as excessive hand-washing, counting, touching, or checking rituals.

How Is Tourette Syndrome Diagnosed?

A diagnosis of TS is based on the presence of both motor and vocal tics that have persisted for more than one year. There is no laboratory test for TS, so the diagnosis is made by a trained specialist through a detailed clinical evaluation.

How Is Tourette Syndrome Treated?

There is no known cure for TS, but there are effective treatments available. The most common and effective treatment is behavioral therapy, which can help to reduce the frequency and severity of tics. Medication may also be used to control tics and associated symptoms such as OCD. In some cases, surgery may be necessary to treat particularly severe tics that do not respond to other forms of treatment.