Tourette syndrome is a neurological disorder. It is a syndrome that involves recurrent involuntary tics, which are repeated, involuntary physical movements and vocal outbursts. The exact cause is unknown.

Tourette syndrome is a tic syndrome. Tics are involuntary muscle spasms. They consist of sudden, recurring twitches of a group of muscles.

The most frequent forms of tics involve:

  • blinking
  • sniffing
  • grunting
  • throat clearing
  • grimacing
  • shoulder movements
  • head movements

According to the American Brain Foundation, about 200,000 people in the United States exhibit severe symptoms of Tourette syndrome.

As many as 1 in 100 people in the United States experience milder symptoms. The syndrome occurs in males nearly four times more often than in females.

Symptoms can vary from one person to another. The symptoms include uncontrollable tics and spontaneous vocal outbursts. They usually first appear between ages 4 and 6, starting with small muscle tics of the head and neck. Eventually, other tics may appear in the trunk (torso) or limbs.

People diagnosed with Tourette syndrome have both a motor tic and a vocal tic. Motor tics involve movement, while vocal tics involve sounds or speech.

The symptoms tend to worsen during periods of:

  • excitement
  • stress
  • anxiety

Symptoms are generally most severe during your early teen years.

Tics are classified by type, as in motor or vocal, such as involuntary speech disorder. Further classification includes simple or complex tics.

Simple tics usually involve only one muscle group and are brief. Complex tics are coordinated patterns of movements or vocalizations that involve several muscle groups.

Motor tics

Simple motor ticsComplex motor tics
eye blinkingsmelling or touching objects
eye dartingmaking obscene gestures
sticking the tongue outbending or twisting your body
nose twitchingstepping in certain patterns
mouth movementshopping
head jerking
shoulder shrugging

Vocal tics

Simple vocal ticsComplex vocal tics
hiccuppingrepeating your own words or phrases
gruntingrepeating other people’s words or phrases
coughingusing vulgar or obscene words
throat clearing
barking

Tourette is a highly complex syndrome. It involves abnormalities in various parts of your brain and the electrical circuits that connect them. If you have Tourette syndrome, an abnormality may exist in your basal ganglia, the part of your brain that contributes to controlling motor movements.

Chemicals in your brain that transmit nerve impulses may also be involved. These chemicals are known as neurotransmitters.

Neurotransmitters include:

It is important to note that there is no test to diagnose Tourette syndrome. Brain imaging and neurotransmitter blood levels appear normal.

Currently, the cause of Tourette syndrome is unknown, and there’s no way to prevent it. Researchers believe that an inherited genetic difference may be the cause. They’re working to identify the specific genes directly related to Tourette.

However, family clusters have been identified. These clusters lead researchers to believe that genetics play a role in some people developing Tourette.

If you are a parent or caregiver of a child who is presenting symptoms like uncontrolled movements or sounds, you should talk with a healthcare professional.

Pay attention to behaviors such as sudden tics, movements, and other behaviors that are involuntary. Reaching out to a healthcare professional will help determine if these symptoms are related to Tourette syndrome or another disorder.

Your healthcare professional will ask you about your symptoms. The diagnosis requires both one motor and one vocal tic for at least 1 year.

Some conditions can mimic Tourette syndrome, so your healthcare professional may order imaging studies, such as an MRI scan, CT scan, or electroencephalogram (EEG), but these imaging studies aren’t required for making a diagnosis. These studies are ordered to rule out other conditions that can cause similar movements, such as a brain tumor or temporal lobe seizures.

People with Tourette often have other conditions as well, including:

If your tics aren’t severe and you experience a more mild form of Tourette syndrome, you may not need treatment. If your tics are severe or cause thoughts of self-harm, several treatments are available. Your healthcare professional may also recommend treatments if your tics worsen during adulthood.

Therapy

Your healthcare professional may recommend behavioral therapy or psychotherapy. This involves one-on-one counseling with a licensed mental health professional.

Behavioral therapy includes:

  • awareness training
  • competing response training
  • cognitive behavioral intervention for tics

Similar therapies can also be helpful for :

Your therapist may also use the following methods during psychotherapy sessions:

You may find group therapy helpful. You’ll receive counseling with other people in the same age group who also have Tourette syndrome.

Medications

There are no medications that can cure Tourette syndrome.

However, your healthcare professional may prescribe one or more of the following drugs to help you manage your symptoms:

  • Haloperidol (Haldol), aripiprazole (Abilify), risperidone (Risperdal), or other neuroleptic drugs. These medications can help block or dampen dopamine receptors in your brain and help you manage your tics. Common side effects can include weight gain, movement problems, and mental fogginess.
  • Onabotulinum toxin A (Botox). Botox injections may help manage simple motor and vocal tics. This is an off-label use of onabotulinum toxin A.
  • Methylphenidate (Ritalin). Stimulant medications, such as Ritalin, can help reduce the symptoms of ADHD without increasing your tics.
  • Clonidine. Clonidine, a blood pressure medication, and other similar drugs can help reduce tics, manage rage attacks, and support impulse control. This is an off-label use of clonidine.
  • Topiramate (Topamax). Topiramate can be prescribed to reduce tics. Risks associated with this medication include cognitive and language problems, drowsiness, weight loss, and kidney stones.
  • Cannabis-based medications. There’s limited evidence that cannabinoid delta-9-tetrahydrocannabinol (dronabinol) may stop tics in adults. There is also limited evidence for certain strains of medical cannabis. Cannabis-based medications should not be given to children, adolescents, or people who are pregnant or nursing.
Off-label drug use

Off-label drug use means that a drug that’s been approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t been approved. However, a doctor can still use the drug for that purpose.

This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.

Neurological treatments

Deep brain stimulation is another form of treatment that’s available for people with severe tics. For people with Tourette syndrome, the effectiveness of this kind of treatment is still under investigation.

To undergo deep brain stimulation, your healthcare professional may implant a battery-operated device in your brain to stimulate parts that control movement. Alternatively, they may implant electrical wires in your brain to send electrical stimuli to those areas.

This method has been beneficial for people who have tics that have been deemed very difficult to treat. You should talk with your healthcare professional to learn about the potential risks and benefits for you and whether this treatment would work well for your healthcare needs.

Living with Tourette syndrome may cause feelings of being alone and isolated. Not being able to manage your outbursts and tics may also cause you to feel reluctant to participate in activities that other people may enjoy.

It’s important to know that there’s support available to help you manage your condition.

Taking advantage of available resources can help you cope with Tourette syndrome. For example, consider talking with a healthcare professional about local support groups. You might also want to consider group therapy.

Meeting and establishing a bond with those who have the same condition can help improve feelings of loneliness. You’ll be able to listen to their personal stories, including their triumphs and struggles, while also receiving advice that you can incorporate into your life.

If you attend a support group but feel it isn‘t a right match, don’t be discouraged. You may have to attend different groups until you find the right one.

If you have a loved one living with Tourette syndrome, you can join a family support group and learn more about the condition. The more you know about Tourette, the more you can help your loved one cope.

The Tourette Association of America (TAA) can help you find local support.

As a parent, it’s important to support and be an advocate for your child, which can include notifying their teachers of their condition.

Some children with Tourette syndrome may be bullied by their peers. Educators can play an important role in helping other students understand your child’s condition, which may help stop bullying and teasing.

Tics and involuntary actions may also distract your child from schoolwork. Talk with your child’s school about allowing them extra time to complete tests and examinations.

Like many people with Tourette syndrome, you may find that your tics improve in your late teens and early 20s. Your symptoms may even suddenly stop entirely in adulthood.

However, even if your Tourette symptoms decrease with age, you may continue to experience and need treatment for related conditions, such as depression, panic attacks, and anxiety.

It’s important to remember Tourette syndrome is a medical condition that doesn’t affect your intelligence or life expectancy.

With advances in treatment, your healthcare team, and access to support and resources, you can manage symptoms of Tourette, which can help you live a fulfilling life.