What Is Tourette Syndrome: Signs, Causes and Treatments

Tourette Syndrome's main symptom is tics or uncontrollable movements which are both physical and vocal.

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Are you wondering what Tourette Syndrome is? Or maybe you’ve heard of it and want to know more.

Tourette syndrome (TS) is a neurological condition that causes uncontrollable tics—sudden, repetitive body movements or sounds. It also includes other symptoms such as trouble paying attention, problems controlling behaviour, and poor self-control.

This article will give you all the information you need to learn about TS.

What Is Tourette Syndrome

Tourette syndrome is a neurological disorder that causes a person to make uncontrollable sounds and repetitive movements known as tics. The syndrome usually starts during childhood, with the average onset between the ages of 3 and 9 years old.

It is common for kids with Tourette’s to be also diagnosed with obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD) or other learning difficulties. According to the Centre for Disease Control and Prevention in the US, boys are three to five times more susceptible to Tourette’s than girls.

While there is no cure for the syndrome, the tics and other symptoms tend to improve and sometimes even disappear after several years. 

Woman with tic | Image from Pexels

What Is Tic Disorder

Tic disorder is a type of movement disorder. It’s characterised by sudden, repetitive, non-rhythmic movements called tics. Tics are involuntary and can be performed as often as several times in a row or once in a while.

People with tic disorders have tics that they can’t control and interfere with their daily lives. The severity of the symptoms varies from person to person. Some people experience mild symptoms, while others have more severe symptoms that affect their ability to function normally.

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Types of Tics

Tics are involuntary, sudden, repetitive movements or sounds. They can be verbal (e.g., throat clearing), motor (e.g., blinking), or vocal (e.g., grunting).

Tics are often preceded by a premonitory urge, which is the feeling that you need to do something. For example, if you have the urge to blink your eyes. Tics may temporarily relieve anxiety and stress but can make you feel embarrassed or self-conscious about them.

Tics are the main symptom of Tourette’s syndrome. But even in that category, there are two main types of tics – motor or physical and vocal. But there are also complex tics. To be diagnosed with Tourette’s, the patient must have at least two motor tics and one vocal tic. 

Motor or Physical Tics

Motor tics are sudden and repetitive movements from a single muscle group. Motor tics are involuntary movements that usually occur in the face, hands, and arms. They can also happen in the legs, torso, and other parts of the body.

The most common motor tic is blinking. Other examples include grimacing or squinting, jerking your head back and forth or up and down, making random sounds like grunts or coughs, and making repetitive movements like flicking your fingers or rubbing your nose.

Motor tics can be hard to control. They may be worse when you’re anxious or excited about something. Motor tics are not dangerous and don’t cause any permanent damage to your body if you have them.

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Image Source: Shutterstock

  • Shoulder shrugging
  • Head twitching
  • Nose wrinkling 
  • Grimacing
  • Blinking

Vocal Tics

Vocal tics are involuntary sounds that people make when they have Tourette syndrome and other nervous system disorders. They can be difficult to control, but using vocal tic suppression techniques can help limit the sounds you make.

People with vocal tics often have difficulty controlling the sounds coming from their mouths. The sounds are involuntary—you don’t control when they happen or what sound comes out.

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Just like motor tics, vocal tics are when a person makes unintentionally, which usually involves one simple sound. Complex vocal tics include yelling, repeating certain words or phrases, and animal sounds.

  • Grunting
  • Throat clearing 
  • Coughing
  • Sniffing 
  • Hissing 

Motor and vocal tics can often happen simultaneously and throughout the day. However, some patients observe that tics become less frequent when concentrating or relaxing. While tics may not be harmful health-wise, physically, they may cause a lot of pain, especially with motor tics like head twitching.

Tics also worsen during stressful times, for instance, when your child may join a school for the first time or during conflicts with friends or family. 

Complex Tics

Complex tics are involuntary, repetitive movements or vocalizations. They include things like eye blinking, shoulder shrugging, or coughing. Complex tics are also known as “repetitive behaviours”. They’re usually not considered a disorder in themselves.

Complex tics can be a symptom of another condition, like Tourette’s syndrome. The symptoms of complex tics are more varied than those associated with simple tics (such as eye blinking or throat clearing), but they’re still involuntary and repetitive.

Image source: iStock

Premonitory Sensation

People with Tourette’s feel a strong urge before a tic, similar to what we feel before sneezing or itching. This is known as a premonitory sensation. The only way to get rid of this feeling is by taking the required action. Some examples of this sensation include a burning feeling in the eyes before blinking, a dry or sore throat before grunting or an itchy joint. 

Causes of Tourette Syndrome

The cause of Tourette syndrome is unknown; however, current research shows that it is due to abnormalities in the brain circuits and neurotransmitters like dopamine and serotonin.  Researchers believe several factors may be involved in its development:

  • Genetics

It also can be due to inheritance; Tourette syndrome tends to run in families, so if you or anybody in your family had Tourette’s, your child is more likely to have the disorder. 

  • Brain structure and function

The brains of people with Tourette syndrome differ from those without the condition. Their brains may have trouble filtering out unwanted information from their surroundings or controlling movement in certain areas of their bodies.

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  • Environment

Environmental factors such as infections or stressful events may contribute to the development of Tourette syndrome.

Complications of Tourette Syndrome

The complications of Tourette Syndrome can be quite severe, and they vary widely from person to person. The most common complications include the following:

  • Stress and anxiety disorders
  • Mood disorders like depression or bipolar disorder
  • Sleep disturbances
  • Behavioural problems like ADHD (attention deficit hyperactivity disorder) and obsessive-compulsive disorder (OCD)
  • Learning disabilities or other cognitive impairments

Symptoms of Tourette Syndrome in Children

Kids with TS experience symptoms at different ages, which may also vary. Some kids have mild symptoms that are barely noticeable; others have severe symptoms that affect their ability to function normally at school or home.

According to Children’s National, some of the most common symptoms of TS in children include:

Involuntary, purposeless motor movements (may involve different parts of the body, such as the face, neck, shoulders, trunk, or hands):

  • Head jerking
  • Squinting
  • Blinking
  • Shrugging
  • Grimacing
  • Nose-twitching
  • Any excessively repeated movements (for example, foot tapping, leg jerking, or scratching)

Some of the more complex tic behaviours associated with TS may appear purposeful and may include the following:

  • Kissing
  • Pinching
  • Sticking out the tongue or lip-smacking
  • Touching behaviours
  • Making obscene gestures

In addition to some, or all, of the above symptoms, TS is also characterised by one or more vocal tics (meaningless sound), for a diagnosis of TS to be made, including the following:

  • Grunting or moaning sounds
  • Barking
  • Tongue clicking
  • Sniffing
  • Hooting
  • Obscenities
  • Throat clearing, snorting, or coughing
  • Squeaking noises
  • Hissing
  • Spitting
  • Whistling
  • Gurgling
  • Echoing sounds or phrases repeatedly

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects children and adolescents.

Many children and adolescents with Tourette syndrome (TS) also have attention problems, including ADHD. Some also have academic difficulties. 

If you suspect your child has TD, it’s important to consult a healthcare provider immediately. The symptoms of TD may resemble other conditions or medical problems.

Treatments for Tourette Syndrome

While there is no cure for Tourette Syndrome, there are treatments to reduce and improve tics. However, most Tourette patients do not require any medication because tics generally do not interfere with body functions. But if it does, narcoleptic drugs are usually prescribed to suppress severe tics. 

Behavioural Therapy 

Behavioural therapy can be done to reduce tics and is provided by a psychologist or a trained therapist. There are two main types of behavioural therapy – habit reversal and exposure with response prevention. Habit reversal training figures out what feelings trigger tics, and exposure to response prevention trains patients to control the urge to tics. 

So parents, if you have a history of Tourette’s in your family or your child is displaying motor and vocal tics, consult your doctor immediately. The earlier you get a diagnosis, the easier it will be for your child to manage his or her symptoms.

Updates from Pheona Ilagan 

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Written by

Shreya Jagdish