Neurology

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.

Tourette Syndrome

Tourette syndrome is a condition that causes uncontrolled sudden, repetitive muscle movements and sounds known as tics

Tourette symptoms typically appear in childhood, usually when kids are between 5–9 years old. It's not very common, and boys are more likely to be affected than girls.

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 Tics

Two types of tics are associated with Tourette syndrome:

  1. Motor tics — sudden, apparently uncontrollable movements such as exaggerated eye blinking, grimacing, head jerking, or shoulder shrugging
  2. Vocal tics — such as repeated throat clearing, sniffing, or humming

Tics are classified as either simple or complex:

  • Simple motor tics usually involve just one group of muscle, such as eye blinking or grimacing.
  • Complex motor tics usually involve more muscle groups and might look like a series of movements. For example, someone might touch a body part or another person repeatedly. In rare cases, people with Tourette syndrome might have a tic that makes them harm themselves, such as head banging.
  • Simple vocal tics can be throat clearing, sniffing, or grunting.
  • Complex vocal tics can involve calling out, repeating other people's words (a condition called echolalia), or involuntary swearing (called coprolalia).

At certain times, like when someone is under stress, the tics can become more severe, happen more often, or last longer. Or, the type of tic may change.

Some kids can hold back their tics for a short time. But as tension builds, 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 Tourette syndrome to have a conversation or pay attention in class.

Causes

Tourette syndrome is a genetic disorder, which means it's the result of a change in genes that's either inherited (passed on from parent to child) or happens during development in the womb.

The exact cause of Tourette syndrome isn't known, but some research points to changes in the brain and problems with how nerve cells communicate. An upset in the balance of neurotransmitters (chemicals in the brain that carry nerve signals from cell to cell) might play a role.

Many kids and teens with Tourette syndrome have other behavioral conditions like attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), learning disabilities, or anxiety. 

Diagnosis and Treatment

To be diagnosed with Tourette syndrome, a child must have several different types of tics — specifically, multiple motor tics and at least one vocal tic  for at least a year. They may happen every day or from time to time throughout the year.

A child with Tourette symptoms may need to see a neurologist, a doctor who specializes in problems with the nervous system. The neurologist may ask the child's parents to keep track of the kinds of tics involved and how often they happen.

There isn't a specific diagnostic test for Tourette syndrome — instead, the health care provider diagnoses it after taking a family history, medical history, looking at the symptoms, and doing a physical exam. Sometimes, imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests can rule out other conditions that might cause symptoms similar to Tourette syndrome.

Just as Tourette syndrome is different for every person, treatment can be different, too. While there isn't a cure for Tourette syndrome, most tics don't get in the way of day-to-day life. If they do, doctors may suggest medicines to help control symptoms.

Tourette syndrome is not a psychological condition, but doctors sometimes refer kids and teens to a psychologist or psychiatrist. Seeing a therapist won't stop their tics, but it can help to talk to someone about their problems, cope with stress better, and learn relaxation techniques. A therapist also can help them with any other problems, like ADHD, OCD, and/or anxiety.

Tics usually are most severe before the mid-teen years. Most people see great improvement in their late teens to early adulthood, though some will have their tics continue into adulthood.

Dealing With Tourette Syndrome

Many people don't understand what Tourette syndrome is or what causes it, so they might not know how to act around someone who has tics. If people stare or comment, kids and teens with Tourette syndrome can feel embarrassed and frustrated. Someone who has it might have to explain the condition to others or deal with teasing or gawking.

These tips can help kids with Tourette syndrome 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.
  • Lend a helping hand. Dealing with Tourette syndrome often makes kids and teens more understanding of other people's feelings, especially other young people with problems. They might use that special sensitivity to volunteer. 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. 
  • Find support. The Tourette Syndrome Association sponsors support groups with others who understand the challenges of Tourette syndrome.
  • Take control. People with Tourette syndrome can feel more in control of their lives by researching the condition, asking their doctors plenty of questions, and taking an active role in their treatment.

Each person with Tourette syndrome will cope differently with its physical, emotional, and social challenges. Tourette syndrome doesn't have to disrupt everyday life, though, and kids who have it can enjoy doing the same things as other kids.

Reviewed by: Shirin Hasan, MD
Date reviewed: November 16, 2016