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Alternative NamesTourette syndrome
Definition Return to top
Gilles de la Tourette syndrome is a disorder of the nervous system that causes a person to make repeated and uncontrolled (involuntary) movements and sounds (vocalizations) called tics. The disorder is commonly called Tourette syndrome.
Causes Return to top
Tourette syndrome is named for Georges Gilles de la Tourette, who first described this disorder in 1885. There is strong evidence that Tourette syndrome is passed down through families, although the gene has not yet been found.
The syndrome may be linked to problems in certain areas of the brain, and the chemical substances (dopamine, serotonin, and norepinephrine) that help nerve cells talk to one another.
Tourette syndrome can be either severe or mild. About 10% of Americans have a mild tic disorder, but far fewer have more severe forms of Tourette syndrome. Many people with very mild tics may not be aware of them and never seek medical help.
Tourette syndrome is four times as likely to occur in boys as in girls.
Symptoms Return to top
Most people first notice symptoms of Tourette syndrome during childhood, between ages 7 and 10.
The most common first symptom is a facial tic. Other tics may follow. A tic is a sudden, rapid, repeated movement or voice sound (vocalization). Tics can include:
Tics may occur many times a day, but they tend to improve or get worse at different times. The tics may change with time.
Contrary to popular belief, use of curse words or other inappropriate words or phrases (coprolalia) occurs in only a small number of patients.
Many patients say that the tics are not totally out of their control (involuntary), but that "things just would not feel right" if they did not do them. This is what makes Tourette syndrome different from obsessive-compulsive disorder (OCD) -- people with OCD feel as though they have to do the behaviors.
Many people with the disorder can suppress the tic for periods of time, but find that when it is allowed to occur after that time, it’s more dramatic for a few minutes.
Exams and Tests Return to top
There are no lab tests to diagnose Tourette syndrome. However, a health care provider should do an examination to rule out other causes of these symptoms.
To be diagnosed with Tourette syndrome, a person must:
Treatment Return to top
Many patients with Tourette syndrome have very minor symptoms. In this case, they are not treated, because the side effects of the medications would be worse than the symptoms of the condition.
Doctors have prescribed medicines called antipsychotics to treat Tourette syndrome. These medicines can help control or reduce tics, but they have side effects such as movement disorders and cognitive dulling. Anti-epileptic medications are also used sometimes.
A blood pressure medicine called clonidine has been shown to help control tics. Another drug commonly used is tetrabenazine, but this drug is also linked to movement disorders as well as depression. Many other treatments have been tried with little or no improvement.
Support Groups Return to top
Tourette Syndrome Association - www.tsa-usa.org
Outlook (Prognosis) Return to top
Symptoms of Tourette syndrome can range from almost unnoticeable minor movements (such as grunts, sniffling, or coughing) to continuing, uncontrollable movements and sounds (vocalizations).
The symptoms tend to get better and worse. Symptoms usually get worse before the mid-teen years. Most patients improve in early adulthood. Although 25% of patients may be symptom-free for a few years, only 8% of patients have symptoms completely go away without returning.
People with Tourette syndrome have a normal life expectancy.
Possible Complications Return to top
Conditions related to Tourette syndrome include:
These conditions need to be diagnosed and treated.
When to Contact a Medical Professional Return to top
Make an appointment with your health care provider if you have tics that are severe or persistent, or if they interfere with your daily life.
Prevention Return to top
There is no known prevention.
References Return to top
Jankovic J. Movement disorders. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 34.
Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.Update Date: 3/26/2009 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.