Tourette's Syndrome / Tic Disorder

What is Tourette Syndrome?

Tourette syndrome (TS) is a neurological disorder characterized by repetitive, involuntary movements and vocalizations known as tics that is often noticed in early childhood.

Tics usually start at about age 2 and may be at their worst by age 12. Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, some people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood. Individuals with Tourette syndrome have a normal life expectancy. Tourette syndrome does not impair intelligence.

Neurological Causes of Tourette Syndrome

Although the cause of Tourette syndrome is unknown, research points to abnormalities in certain brain regions such as the basal ganglia, frontal lobes, and cortex, as well as the interconnections between these regions and the neurotransmitters (dopamine, norepinephrine and serotonin) responsible for communication among nerve cells.

What is a Tic?

People with Tourette syndrome will experience different patterns of tics including bursts of movement or sounds that last for seconds or minutes.

The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. 

Tics can include:

  • Twitching of the eyes
  • Jerking of the neck
  • Coughing
  • Throat-clearing
  • Yelling
  • Grunting

Tics are characterized as either simple or complex.

Simple Motor Tics

Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. More common simple tics include eye blinking, facial grimacing, shoulder shrugging, and head jerking and shoulder jerking.

Simple Vocalized Tics

Simple vocalizations include involuntary repetitive throat-clearing, sniffing, or grunting.

Complex Motor Tics

Complex tics are distinct, coordinated patterns of movements involving multiple muscle groups. Complex motor tics can include facial grimacing combined with a head twist and a shoulder shrug. Complex motor tics may actually seem purposeful but are completely involuntary. They can including sniffing or touching objects, hopping, jumping, bending, or twisting.

The most disabling and dramatic looking tics include motor movements that result in self-harm. For example, punching yourself in the face.

Complex Vocalized Tics

Complex vocal tics include words or phrases instead of just sounds. This includes vocal tics like coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others).

Coprolalia is actually rare within Tourette syndrome, however, it is such a dramatic symptom that Tourette syndrome has become stereotyped by it. It is important to remember, however, that most people who suffer with Tourette Syndrome do not exhibit this symptom.

Can Tics be Controlled?

Tics in response to an environmental trigger may appear to be voluntary or purposeful, but they are not. Although the symptoms of Tourette syndrome are involuntary, some people with the disorder can sometimes suppress or manage their tics. However, patients often report a substantial buildup in tension when suppressing their tics. Eventually the tic must be expressed and often suppressed tics end up being much worse. Tics are often worse when someone is surrounded by excitement, anxiety or stress.

How is Tourette Syndrome Diagnosed?

There are no tests to diagnose Tourette syndrome, but your doctor can diagnose Tourette syndrome by verifying that the patient has had motor and vocal tics for at least 1 year.

There are no blood or laboratory tests needed for diagnosis, but neuro-imaging such as magnetic resonance imaging (MRI), computerized tomography (CT), and electroencephalogram (EEG) scans may be needed in order to rule out other conditions.

How is Tourette Syndrome Treated?


Effective medications are available for those whose symptoms interfere with functioning. Unfortunately, there is no one medication that is helpful to all people with Tourette syndrome, nor does any medication completely eliminate symptoms.  Effective medications are also available to treat some of the associated neurobehavioral disorders that can occur in patients with Tourette syndrome.


Treatment for Tourette syndrome needs to focus on helping your child learn to cope with tics. If tics are seriously affecting your child’s quality of life at home or school, then counseling and behavioral therapy may help. Psychotherapy can help the person with TS better cope with the disorder and deal with the secondary social and emotional problems that sometimes occur.