Nerves are like messengers. They’re in constant touch with the body’s organs and muscles, delivering commands from the brain and bringing information back to it. When something goes wrong with the flow of information between the brain and the rest of the body, either because of an injury or a health condition, your child might need to see a pediatric neurologist (“nu-ROL-o-jist”) – a doctor who treats neurological disorders in children.
But in some kids, tics are more severe or long lasting. If a child has tics for more than a year, it is called a chronic tic disorder. In some cases, these tics can be part of a condition called Tourette syndrome.
The tics associated with Tourette syndrome tend to get milder or go away entirely as kids grow into adulthood. Until that happens, though, parents can help their child cope with the condition.
About Tourette Syndrome
Tourette syndrome (TS) is named for French doctor Georges Gilles de la Tourette, who first described the condition in 1885. It's thought to be a genetic condition that's inherited in most cases. Experts don't know the exact cause of TS, but some research points to changes in the brain and problems with how nerve cells communicate. A disturbance in the balance of neurotransmitters — chemicals in the brain that carry nerve signals from cell to cell — might play a role.
Symptoms of Tourette syndrome, which is not contagious, usually emerge in childhood or the teen years. TS isn't common — only about 3 in every 1,000 people have it, and boys are more likely to be affected.
To be diagnosed with Tourette syndrome, a person must have several different types of tics — specifically, multiple motor tics and at least one vocal tic.
Signs and Symptoms
The main symptoms of TS are motor tics (sudden, apparently uncontrollable movements like exaggerated blinking of the eyes) or vocal tics (such as repeated throat clearing).
At certain times, like when someone is under stress, the tics can become more severe, more frequent, or longer, or the type of tic may change altogether. (This is also true of people who have tics that are not part of Tourette syndrome.)
Some kids can suppress their tics for a short time. But tension builds, and it eventually has to be released as a tic. And if a person is concentrating on controlling the tic, it may be hard to focus on anything else. This can make it hard for kids with TS to have a conversation or pay attention in class.
Tics are classified as either simple or complex. Simple motor tics, for example, happen suddenly and separately from other tics and involve just a few muscles. Some examples are eye blinking and grimacing. In contrast, complex motor tics usually involve more muscle groups. For example, someone might touch a body part or another person repeatedly. In rare cases, people with TS might have a tic that makes them harm themselves, such as head banging.
Simple vocal tics can be throat clearing, sniffing, or humming, whereas complex vocal tics can involve repeating other people's words (a condition called echolalia) or involuntary swearing (called coprolalia).
In addition, many kids and teens with TS have other conditions, such as attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). Learning disabilities and sleeping problems are also common in people with TS.
Diagnosing and Treating Tourette Syndrome
Pediatricians and family doctors may refer a child with symptoms of TS to a neurologist, a doctor who specializes in problems with the nervous system. Before TS can be diagnosed, someone must have tics for at least a year. Although tics may occur every day or intermittently throughout the year, for TS to be diagnosed, there must not be a tic-free period longer than 3 months. The neurologist may ask you to keep track of the frequency and kinds of tics your child is having.
There isn't a specific diagnostic test for TS — instead, the doctor diagnoses it after taking a medical history and doing a physical exam. Sometimes, doctors use imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests to rule out other conditions that might have symptoms similar to TS.
Just as TS is different for every person, the treatment for it varies, too. Most tics do not interfere with a child's life and do not require any medication. While there isn't a cure for TS, sometimes doctors suggest medications to help control symptoms that begin to interfere with someone's schoolwork or daily life. Talk to your doctor about whether medication would be right for your child.
TS is not a psychological condition, but doctors sometimes refer kids and teens with TS to a psychologist or psychiatrist. Seeing a therapist won't stop tics, but it can help kids and teens to talk to someone about their problems, cope with stress better, and learn relaxation techniques.
Dealing With Tourette Syndrome
Many people don't understand what TS is or what causes it, so they might not know what to make of someone who has TS. And if people stare, kids and teens with TS can feel embarrassed and frustrated. Someone who has it might have to explain the condition to others or deal with teasing or gawking.
The tics usually get milder as kids grow up and might go away in adulthood. But until then, these tips can help kids with TS cope:
- Get involved. Some experts say that when kids and teens are engrossed in an activity, their tics are milder and less frequent. Sports, exercise, or hobbies are great ways for kids to focus mental and physical energy. Some well-known athletes have TS, like soccer goalie Tim Howard, who plays for Everton (in the English Premier League) and for the U.S. national team.
- Give a helping hand. Dealing with TS often makes kids and teens more understanding of other people's feelings, especially other young people with problems. They might use that special sensitivity by volunteering. Knowing that they've helped others might help build confidence and lessen any self-consciousness about feeling different.
- Embrace creativity. Creative activities such as writing, painting, or making music help focus the mind on other things — and they help it develop. There's speculation that composer Mozart and British writer Samuel Johnson both had TS.
- Find support. The Tourette Syndrome Association sponsors support groups with others who understand the challenges of TS.
- Take control. People with TS can feel more in control of their lives by researching TS, asking their doctors plenty of questions, and taking an active role in their treatment.
Each person with TS will cope differently with its physical, emotional, and social challenges. Because TS doesn't usually restrict activities, though, kids who have it should be able to enjoy and participate in the same activities as their peers, and not let it interfere with their everyday lives.
Reviewed by: Harry S. Abram, MD
Date reviewed: September 2010