Tourette syndrome is a neurological condition that causes sudden, repeated movements and sounds called tics. It is diagnosed when several motor tics and at least one vocal tic have been present for at least 12 months. Tics usually begin around the age of 6.
Key points
- Tourette syndrome is a neurological condition causing sudden, repeated movements and sounds, called tics.
- Swearing as a tic (coprolalia) is the best known feature and the least typical, at an estimated 10% to 30% of cases.
- Most tics follow a building sensation, the premonitory urge, that the tic relieves, so they can be held back only briefly.
- Up to 85% of people with Tourette syndrome also have ADHD, OCD or anxiety.
- Behavioural therapy comes before medication, though few UK clinicians deliver it, and about half of children improve by adulthood.
Symptoms
- Simple motor tics: blinking, eye rolling, grimacing, shoulder shrugging; complex motor tics: jumping, twirling, touching things.
- Simple vocal tics: throat clearing, sniffing, coughing, grunting; complex vocal tics: phrases out of context, echolalia.
- A building sensation before a tic, relieved by the tic, similar to needing to sneeze or scratch an itch.
Causes and risk factors
- Inherited risk and differences in the brain circuits controlling movement; runs in families, more likely if a parent has it.
- Not caused by parenting; stress, excitement and tiredness make tics more frequent without causing them.
Treatment
- Habit reversal training: a competing response, a deliberate movement that blocks the tic, worked out from the premonitory urge.
- No medicine is licensed specifically for tics in the UK; groups used include dopamine-acting drugs and noradrenergic medicines such as clonidine and guanfacine.
- Functional tic-like behaviours are a different, more sudden-onset presentation treated with psychological therapy or physiotherapy rather than tic medication.
When to speak to a professional
- Tics are causing pain, injury or exhaustion, or are getting in the way of school, work or sleep.
- Tics started suddenly and severely, or first appeared in adulthood, since functional tics are treated differently.
If you need help now: Samaritans, call 116 123, free, 24/7. Shout, text SHOUT to 85258. NHS 111, then choose the mental health option. Call 999 if anyone is in immediate danger.