What is Tourette's disorder?

Tourette's disorder is a neurological (brain) condition that usually begins in childhood. It causes a child to make sounds or words (vocal tics) and body movements (motor tics) that are beyond his or her control. Tourette's disorder (TD) is also known as Tourette's syndrome and Gilles de la Tourette syndrome. Not all tics are from TD. Your child may have tics and not develop TD.

Motor tics usually begin between ages 2 and 8. Vocal tics can begin as early as age 2, but they usually start a few years after motor tics. Tics generally are at their worst about age 12. In most children, tics go away or decrease quite a bit in the teen years. But tics can continue into adulthood.

The effect tics have on children varies. Some children have mild tics that have a small impact on their lives. But even mild or infrequent tics may affect your child's self-esteem and relationships with friends and family. Severe and frequent tics may require treatment, including medicine and counseling. Although a child's tics may seem minor, they may interfere with the child's ability to learn and can cause embarrassment.

It is important to remember that:

• Tics are not a sign of low intelligence and do not affect intelligence.
• The severity of your child's tics is not a good indicator of how well he or she will perform in school or in social situations.
• How well your child can cope with tics can be helped by a supportive home, school, and community environment.

What causes Tourette's disorder?

TD is thought to have a genetic component. This means that having a certain gene or mix of genes makes a person likely to develop the condition. The exact gene or genes have not been identified. After answering a doctor's detailed questions about the family's medical history, many parents of a child with TD are surprised to learn that other family members may have also had symptoms of the condition.

Other things that may increase a person's risk for developing tics or TD include having:

• A mother who suffered from severe nausea and vomiting during the first trimester of pregnancy, was under severe stress during her pregnancy, or drank a lot of coffee, smoked cigarettes, or drank alcohol during her pregnancy.
• Insufficient oxygen or blood supply during birth.
• A low birth weight and signs of brain injury or an enlarged section of the brain.
• A lower birth weight than an identical twin.
• Abnormal evaluation results right after birth (low Apgar scores).
• PANDAS. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) can affect tic development. It may make tics worse in children with tics, and it may also cause children who have not had tics to suddenly develop them. More research is needed to study this process.

What are the symptoms?