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Tourette's syndrome

Published by Bupa's health information team, March 2008.

This factsheet is for people with Tourette's syndrome, or who would like information about it.

Tourette's syndrome, also called Tourette syndrome, is a complex condition that affects the nervous system. It causes you to make involuntary movements and sounds known as tics. It's thought that about one in 200 people are affected, but it's likely that more people have it but aren't diagnosed because they only have mild symptoms. Some people with Tourette's syndrome take medicines to relieve the symptoms, but many people don't need to.

About Tourette's syndrome
Symptoms
Complications
Causes
Diagnosis
Treatment
Living with Tourette's syndrome
Further information
Questions and answers
Related topics
Sources

About Tourette's syndrome

The full name for Tourette's syndrome is Gilles de la Tourette's syndrome, named after the doctor who first described its symptoms. The condition is characterised by making movements and noises that you can't control. These are called tics and vary from person to person.

Tourette's syndrome usually begins at about the age of six or seven years old. Boys are three to four times more likely to have it than girls. You will probably have the condition throughout your life, but it's likely that the symptoms will decrease as you get older.

Symptoms

There are many different types of both movement (motor) and sound (vocal) tic. They may be either simple or complex.

Simple tics

Some examples of simple tics include:

blinking
head jerking
shoulder shrugging
facial twitches/grimaces
sniffing
clearing your throat
grunting
tongue clicking

Complex tics

Complex tics are more extreme - some examples include:

jumping
squatting
touching other people or things
twirling
copying other people's movements
making obscene gestures (copropraxia)
swearing or saying obscene words (coprolalia)
repeating words/phrases
saying things out of context

The symptoms of Tourette's syndrome tend to come and go, often with one tic going and being replaced by a different one. You may also find your tics change as you get older. Tics are completely unpredictable, but you may be able to control them with relaxation techniques or by concentrating on something. You may find your tics are worse when you are feeling stressed or anxious.

Complications

You may have other conditions such as attention deficit hyperactivity disorder (ADHD) or obsessive compulsive behaviour. Some people also have trouble sleeping and feel anxious or depressed. This may make it harder for you to manage your condition.

Causes

Tourette's syndrome is thought to occur because something goes wrong with the development of your brain and spinal cord (together these are called the central nervous system). Chemicals called neurotransmitters help to process messages in your nervous system and these may be disrupted.

The exact reasons why you may develop Tourette's syndrome are not fully understood at present. The condition does appear to be inherited - if you have Tourette's syndrome, there is a 50 percent chance that each of your children may also inherit the gene or genes that cause the condition. However, your child won't necessarily develop Tourette's syndrome. If your child does, he/she may not have the same tics as you.

For some people, no family link can be found. This is called sporadic Tourette's syndrome and its cause isn't known.

Some research has shown that Tourette's syndrome might be set off by an infection caused by a Group A Streptococcus bacterium. When your body's immune system attacks harmful substances such as bacteria, it produces antibodies. It's possible that in some people, when this happens during a Group A Streptococcus infection, the antibodies damage specific nerve cells which then no longer work properly.

Diagnosis

Tourette's syndrome is diagnosed from the symptoms. According to the Tourette Syndrome (UK) Association, the condition is only diagnosed if you have had several movement tics and at least one noise tic for a minimum of a year. Any periods during this time when you haven't had any tics must have lasted for less than three months.

If the symptoms are only mild, it can be difficult to diagnose Tourette's syndrome. It's likely that some children who have Tourette's syndrome are misdiagnosed as having other conditions, such as ADHD.

Your GP may refer you for further tests to check that your symptoms are not being caused by another condition. Children may also be referred to a paediatric neurologist (a doctor specialising in identifying and medically treating conditions that affect the nervous system, including the brain, in children) or a child psychologist.

Treatment

It's very likely that you will be able to cope with the symptoms of Tourette's syndrome and won't need any specific treatment. However, if your tics cause you serious problems, there are treatment options available.

Medicines

You may be prescribed medicines called neuroleptics such as haloperidol. These reduce your symptoms. They are usually used to treat conditions such as schizophrenia because they have a tranquilising effect. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

It's important to remember that as with all medicines, you may have side-effects as a result of taking neuroleptics. These may include:

restlessness - your symptoms may actually seem worse, especially after a strong first dose
jerky or unusual face and body movements

Other treatments

You may find psychotherapy helpful. There are lots of different types, but they are all talking therapies. By talking to another person, you may be able to reduce your symptoms. If stress is a problem and causes your symptoms to get worse, psychotherapy may help you to relax and overcome this.

Behavioural psychotherapy aims to change the way you behave - this may be particularly useful if you have problems with obsessive compulsive behaviour.

Living with Tourette's syndrome

It's very likely that with support and advice from doctors and family, you will be able to manage your condition and live a normal life. Tourette's syndrome doesn't affect your intelligence and it often improves as you get older, sometimes going away completely.

Further information

Tourette Syndrome (UK) Association
0845 458 1252
www.tsa.org.uk