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Associated Disorders   Related Difficulties   Cause   Treatment   Long Term

Tourette Syndrome (or TS) is a neurological disorder characterized by involuntary movements and sounds, referred to as tics. In recent years, the number of people diagnosed with TS has increased. The National Institutes of Health estimate that in the United States, approximately 100,000 people have TS. Some studies indicate that the number may be closer to 200,000. The incidence of the disorder tends to be greater in males than in females. Cases of TS have been reported throughout the world without differentiation based on race, culture, or socioeconomic level.

Tics are the most noticeable symptom of TS. A tic is a physical or verbal behavior that people with TS do, even though they have no control over it. People with TS have motor and vocal tics, and these tics can be simple or complex. Examples of simple and complex motor and vocal tics are provided below.

Some people have tics but do not have TS. To be diagnosed with TS, someone must have both motor and vocal tics; these tics must have started before the person was 18 years of age, but tics usually start when a child is between 5 and 8 years of age.

Tics are involuntary; while some people can suppress them for a while, the tics usually emerge more intensely after this period of suppression. Imagine trying not to blink; after a while, you would just have to do it. An individual's tics change over time, involving different parts of the body and different sounds. Also, tics increase and decrease in severity at irregular intervals. This waxing and waning of symptoms is considered a hallmark of TS.

A relatively rare but well-publicized type of complex vocal tic is called coprolalia, in which the person involuntarily utters obscene or profane words. While this type of TS is often shown in the media, it is actually a very rare behavior for people with TS.

Associated Disorders

In some cases, TS is accompanied by other disorders. Approximately 50 to 75 percent of individuals diagnosed with TS have problems with attention, hyperactivity, and impulse control. Some people with TS and also attention and hyperactivity symptoms may have temper outbursts, mood swings, confrontational behavior, and aggression. It is unclear whether these behaviors are part of the disorder, associated disorders, or caused by the frustration and anxiety experienced by people with TS.

Obsessive-compulsive symptoms affect approximately half the population with TS. Compulsions are repeated actions or behaviors that a person feels he or she must do, usually in response to a fear of unwanted consequences. These include checking rituals, repeated touching, or hand washing. Obsessions are recurring, unwanted thoughts or images that intrude upon one's mind and interrupt schoolwork or other tasks. Such thoughts are sometimes referred to as "mental tics" and, in some ways, can be more distracting than motor tics.

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Related Difficulties

TS can cause difficulties for individuals that are separate from the TS symptoms themselves. A person with TS may feel tired from the physical exertion involved both in expressing tics and in trying to suppress them. Some of the medications used to treat severe tic symptoms have undesirable side effects, such as sleepiness or weight gain. A person with TS may be frustrated by not having control over his or her own body. A child with TS may be depressed because other children tease him or her or react to his or her strange symptoms by excluding that child. Children with TS may express their frustration by acting out, which can further isolate them from their peers. Many related difficulties are more profound when the TS is accompanied by an associated disorder or disorders.

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Cause

Research has determined that TS is primarily an inherited disorder that may be expressed in a child even if the parent does not exhibit any symptoms. Genetic studies have not found a single "TS gene" that causes the disorder, so the pattern of inheritance may be complicated. Studies have suggested that tics are caused by differences in the neurotransmitter chemicals in the brain, specifically a hypersensitivity to dopamine, the neurotransmitter that carries messages about movement. Many researchers are investigating the brain and genetic basis of TS, so knowledge about the cause or causes of the disorder is growing.

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Treatment

While there is no cure for TS, medications can decrease symptoms of the disorder. The type of medication used depends on the symptoms that are most troubling for a specific individual and how that individual responds to the medications. Medications differentially diminish tics, obsessions and compulsions, anxiety, inattention, and hyperactivity. However, side effects are likely, and adjustments to the type of medications and dosage may be necessary to find the right fit for the child.

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Long Term

While there is no cure for TS, the symptoms often become less severe as individuals grow older. TS is NOT a degenerative condition and is NOT life-threatening. TS does NOT impair intelligence. Individuals with TS live normal, healthy lives. People with TS are in every profession and enjoy all kinds of recreational activities.