Tourette syndrome

Tourette’s is a condition that causes sudden, repeated muscle movements or spasms, referred to as ‘tics’ or motor tics. 

Voice (vocal) tics can also occur, including meaningless sounds like grunts, repeating words others say, and unintended swearing (called coprolalia).

 In Tourette’s, the chemicals in your brain that give your body messages about movement and the use of your voice are affected. This is what causes the tics.

Tourette’s usually begins in childhood. Although symptoms continue into adulthood and are with you for life, most people with Tourette’s experience the worst of their symptoms in their early teens. Through late teens and into adulthood, symptoms usually improve.

Your intelligence and life expectancy are not affected by Tourette’s and there is a range of treatments, such as cognitive behavioural therapy (CBT) and medication, to help control severe tics.

Most people who have Tourette’s have mild cases and do not need medical treatment. It's important to remember that Tourette’s may diminish in adulthood, but for most it will come and go, and symptoms may change over time.

What causes Tourette’s?

Tourette’s is thought to be an inherited condition (passed on in families), though the exact cause is still unknown.  More boys than girls are diagnosed with Tourette’s, outnumbering girls by three to one, although it is not understood why this is so.

Tourette’s can occur in association with other conditions, such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), anxiety or depression.

Signs to look for (symptoms)

Tourette’s usually begins between the ages of two and 12 years.  The first sign you may notice may be simple tics such as:

• excessive blinking
• twitching of the nose
• grimacing – making faces.

Other signs of Tourette’s could be:

• meaningless sounds such as grunts, barks or repeated sniffing
• involuntary head shaking, shoulder jerking, arm flapping, foot stamping
• unintended use of swear or obscene words (occurs in about 30% of cases)
• unintended repetition of a word or sentence spoken by the person or someone else
• unintended imitation of other people’s movements
• self-mutilating behaviour (sometimes).

Remember that not all these signs may appear at the same time.

How the doctor tests for Tourette’s (diagnosis)

When your doctor is testing for Tourette’s in you or a family member they will check that both movement and voice tics have been present for at least a year before a diagnosis of Tourette’s can be made. 

People with Tourette’s often have associated conditions (see above) that the doctor will look for.

Treatment options

Mild cases may not require treatment.  For others there are a number of treatment options your doctor will discuss with you. These options include:

Medication

If your tics are interfering with you being able to function in your daily life your doctor will look at giving you medication to help control them.  Your doctor will talk to you about what medications they are recommending and what that means to you and your family. 

If you are prescribed medication you are entitled to know:

• the names of the medicines
• what symptoms they are supposed to treat
• how long it will be before they take effect
• how long you will have to take them for and what their side effects (short and long-term) are. 

Each person’s reactions to medication is different so it is especially important for you to talk with your doctor regularly to make sure you are not experiencing unhelpful side effects. It is important to see your doctor before stopping medication. A sudden stop can cause worse feelings.

Psychological (behavioural) therapies

These may be considered on their own or alongside medications.

Cognitive-behavioural therapy (CBT) may help in controlling tics. This trains you to voluntarily move in response to the feeling you get just before a tic occurs and is intended to help change your body’s behavior over time to lessen tics.

Other types of psychotherapy or counselling may be considered as it is can help people, especially children and teenagers, understand what has happened to them and how to make positive changes in their lives. 

Complementary therapies

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it.

Certain complementary therapies may enhance your life and help you to maintain wellbeing. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.

When considering taking any supplement, herbal or medicinal preparation you should consult your doctor to make sure it is safe and will not harm your health, for example, by interacting with any other medications you are taking.

Physical health

It's also really important to look after your physical wellbeing. Make sure you get an annual check up with your doctor. Being in good physical health will also help your mental health. 

Helping your child

Children with Tourette’s need a supportive family and learning environment.

It‘s important that children are encouraged to develop and learn coping behaviours and skills and that parents help children learn and practice coping as well as relaxation skills. Using concentration for specific tasks (being absorbed in an activity) can reduce the number of tics.

You should discuss your child’s needs and symptoms with their school. It’s important their teachers understand their behavior, and be informed if they are taking medication that could affect their school work or daily life. Teachers can have a positive impact on your child’s development if they understand the problems that might be present. 

Thanks to Janet Peters, Registered Psychologist for reviewing this content. Date last reviewed:  September, 2014.