Tourette Syndrome

Medically Reviewed by Zilpah Sheikh, MD on October 15, 2024
Written by Stephanie Watson
10 min read

Tourette syndrome is a neurological (nervous system) tic disorder. It causes people to make sudden movements or sounds they can’t control. These are called tics. For example, someone with Tourette's might blink or clear their throat over and over again. Some people may blurt out words they don't intend to say.

Some treatments may help control tics, but some people don’t need to take medications unless their symptoms bother them.

About 100,000 Americans have full-blown Tourette syndrome, but more people have a milder form of the disease. It often starts in childhood and affects more boys than girls. Symptoms often get better as children grow up. For some people, they go away completely.

Tourette syndrome is also sometimes called Tourette's  or Tourette disorder.

Doctors don’t know yet what causes Tourette syndrome. It’s been linked to different parts of the brain, including the basal ganglia, frontal lobes, and cortex. The basal ganglia is the area that helps control body movements. The frontal lobes manage muscle control, among other things, while the cortex plays a role in how some parts of the brain communicate with each other. Researchers think that disruption in this brain network causes Tourette syndrome.

It could also result from abnormalities in neurotransmitters, which are cells that transmit messages to the brain. These include dopamine, serotonin, and norepinephrine.

There are other possible causes, but they haven’t been proven. They include:

  • Difficult pregnancy
  • Low birth weight
  • Head injury
  • Carbon monoxide poisoning
  • Encephalitis

Is Tourette syndrome genetic?

Researchers believe that some part of Tourette syndrome or a milder form of tic disorder might be genetic, passed down through families. It’s not clear yet how this happens, but someone with Tourette's has a 50% chance of passing it down to a child. Some families have clusters, groups of people who have Tourette syndrome while other families may just have one affected member. That said, up to 1 in 20 children with Tourette's don’t have it in their family.

Tourette syndrome does affect more boys than girls.

Tics are the symptoms of Tourette syndrome. Some are too mild to be noticeable. Others happen often and are obvious. Stress, excitement, or being sick or tired can make them worse. Severe tics can be embarrassing and can affect your social life or work.

Before a motor tic appears, you may get a sensation that can feel like a tingle or tension. The movement (the tic) makes the sensation go away. You might be able to hold your tics back for a little while, but you probably can't stop them from happening.

There are two types of Tourette syndrome tics: motor tics (which involve body movements) and vocal tics (which involve your voice). Each of these types can be further divided into simple and complex tics.

Motor tics

Motor tics involve motor movement, and they can be simple or complex. Simple motor tics affect only a few parts of your body and might cause:

Complex motor tics typically involve more than one part of your body at a time. They include:

  • Grimacing, twisting your head, and shrugging
  • Hopping
  • Jumping
  • Twisting

Vocal tics

Like motor tics, vocal tics can be simple or complex. Simple vocal tics include:

  • Barking or yelping
  • Clearing your throat
  • Coughing
  • Grunting

Complex vocal tics include:

  • Repeating what someone else says
  • Repeating your own words

Tourette's and swearing

One of the most puzzling symptoms of Tourette syndrome is coprolalia — the medical term for involuntarily swearing or making socially inappropriate or offensive comments. There is a motor equivalent of coprolalia called copropraxia. This is a complex motor tic that involves making obscene gestures. Television and movie portrayals of people with Tourette’s often use these tics for effect, so they may seem common, but they’re not. Most people with Tourette’s do not have coprolalia or copropraxia.

Researchers believe this happens when the brain messages that stop people from making those comments or movements are mixed up. And just as unwanted motor tics can happen, swearing or inappropriate language and behavior may come out without you being able to stop it.

Other symptoms

Doctors aren’t sure why, but about half of people with Tourette's also have symptoms of attention deficit hyperactivity disorder (ADHD). You may have trouble paying attention, sitting still, and finishing tasks.

Tourette syndrome can also be associated with:

  • Anxiety
  • Learning disabilities, such as dyslexia
  • Obsessive-compulsive disorder (OCD) — thoughts and behaviors you can't control, such as washing your hands over and over again

Tourette syndrome is most often diagnosed in children but it’s possible to be diagnosed as an adult. 

There are no specific tests for Tourette syndrome. So if you’re concerned you or your child have it, the diagnosis is based on the information you provide and what the doctor sees. They might have to rule out other problems that cause tics though. Sometimes, tics have a simple explanation; for instance, constant blinking may be due to vision problems, or excessive sniffing may result from allergies. In such cases, you or your child might be sent for tests such as blood tests or imaging tests (such as an MRI). Another test that might be recommended is an electroencephalogram (EEG), which looks at your brain waves.

The questions your doctor might ask could include:

  • What did you notice that brought you here today?
  • Do you or your child often move your body in a way you can’t seem to control? How long has that been happening?
  • Do you or your child ever say things or make sounds without meaning to? When did it start?
  • Does anything make the symptoms better? What makes them worse?
  • Do you or your child feel anxious or have trouble focusing?
  • Does anyone else in your family have these kinds of symptoms?

Your doctor will also evaluate certain criteria, such as if the tics:

  • Are both motor and vocal (but they don’t have to be at the same time).
  • Have been occurring for at least a year, regardless of how often they appear in a day
  • Began before age 18 (for adults who are being evaluated).
  • Aren’t caused by medications or other substances.
  • Are changing in frequency, type, severity, or from simple to complex (or the other way around).

Questions for your doctor

Learning about Tourette syndrome can be overwhelming. Here are some questions you may ask your doctor to understand what it means to have Tourette syndrome.

  • Do I need any more tests?
  • How long will these symptoms last? Will they ever go away?
  • What kind of specialists do I need to see?
  • What types of treatments are available?
  • Do the treatments have any side effects?
  • What is watchful waiting and how does that help my child?
  • Would therapy with a psychologist or psychiatrist be helpful?
  • Will my child need help at school?
  • If I have children, what are the chances they will have Tourette syndrome?
  • How long will the tics last?

There is no cure for Tourette syndrome. For many people, the tics are mild and don't need to be treated. If they become a problem though, your doctor may prescribe medication. It can take a while to find the right dose that helps control tics but avoids or limits side effects, so you and your doctor will need to work together to find what works for you.

Medication for Tourette syndrome

There are several types of medications your doctor can choose from. You might recognize some of the names as drugs used to treat other diseases or disorders. This is because they’re drugs that were originally approved for those conditions, but doctors found that they also can help reduce tics. They include:

Therapy

There are a few types of therapy that could be useful for some people with Tourette syndrome. 

Talk therapy or psychotherapy

This type of therapy, usually with a psychologist or trained therapist, helps you learn how to deal with Tourette syndrome, as well as other problems that you may have. For example, you may also be dealing with ADHD, obsessions, depression, or anxiety. Dealing with one condition could help you manage others.

Cognitive behavioral therapy (CBT)

Like psychotherapy, cognitive behavior therapy (CBT) is done with a psychologistor trained therapist. The goal is to help you identify certain behaviors and modify them or your reaction to them. There is a type of CBT that is specific for Tourette syndrome, called Cognitive Behavioral Interventions for Tics.

Deep brain stimulation (DBS)

This type of therapy is in the early research stages for Tourette syndrome that doesn’t respond to other treatments and is so severe that it’s affecting your life. Researchers don’t know yet if it’s effective. DBS involves implanting a device into your brain. Once in place, the device sends out electrical impulses to stimulate the target areas that control movement.

Often, the hardest part of living with Tourette's is dealing with the embarrassment or frustration of having tics you can't control. While you're getting help from your doctor, you can do a few other things to feel better:

Educate yourself and others. Educating yourself about Tourette syndrome is important, but so is educating family and friends. The more they know about the condition, the better they can help you. You can give them pamphlets or brochures if you have any, or you can send them to a Tourette syndrome association site, such as the Tourette Association of America.

Get support. Your family, friends, health care team, or a support group can help you meet the challenges of Tourette's. Ask for that support and tell them what it is you need from them.

Follow your treatment plan. Whether it’s meeting with a therapist or taking medications, be sure to follow your treatment plans. If you have trouble doing this, speak with your doctor. There may be other things you can do.

Stay active. Play sports, paint, or volunteer — anything that helps keep you busy and helps you feel good. These activities may take your mind off your symptoms.

Relax. Read a book, listen to music, meditate, or do yoga. Low-key activities you enjoy can combat the stress that can lead to tics.

Parenting a child with Tourette syndrome can be challenging. In many cases, Tourette syndrome tics peak when children are in their early teens, and they improve as they get older. 

In the meantime, here are some things that might help:

Don’t tell or ask your child to stop their tics. It can be frustrating to see or hear the tics, but asking your child to control them can add to their stress and make the tics worse.

Speak to the adults in your child’s life. Talk to the staff at their school about your child’s diagnosis. You can give them the facts about the condition and see what kind of support they can provide, such as extra tutoring or smaller classes, perhaps. You can also inform the school bus driver, after-school day care staff, coaches, tutors, and anyone else who your child interacts with regularly.

Help build your child’s self-esteem. Every child has different interests, so it can take time to find the right ones for your child, but once you do, this can make a big difference. They can form friendships and learn new things that help build their self-esteem.

Join support groups. See if you can find a local Tourette syndrome support group for parents. If there isn’t one available, maybe you could start one! 

Practice with your child. Fitting in socially also can be hard for a child with Tourette syndrome. Help them practice ways to handle teasing or comments from other kids.

Tourette syndrome causes a range of tics, from mild to severe. For those with mild to moderate tics, there may be no other issues for them to deal with. However, there are people with Tourette syndrome who also have to deal with other conditions at the same time. The ones most often associated with Tourette syndrome are:

Tourette syndrome, also called Tourette's or Tourette disorder, can affect anyone, but it affects more boys than girls. Most people with Tourette syndrome have symptoms that start in childhood, peak in the early teen years, and then lessen. There’s no cure for the condition, but there are treatments and therapies that could lessen the strength of the tics.

Can Tourette’s go away?

About one-third of children with tics from Tourette syndrome get better after their early teens. Another third stay the same, while the rest get worse. However, only about 2%-5% of those in the last group need significant help.

What are some of the early signs of Tourette syndrome in children?

Some early signs of Tourette syndrome in children include squinting their eyes or blinking a lot, shrugging, grimacing, twitching their nose, jerking their head, and foot tapping or stomping.

Is Tourette’s related to anxiety?

Anxiety doesn’t cause Tourette syndrome, but it can make the tics worse.

Can you live a normal life with Tourette’s?

Most people with Tourette’s do go on to live a normal, active life.

What not to do to someone with Tourette’s

An important thing not to do with someone who has Tourette syndrome is to tell them to stop or control their tics. This can trigger stress and anxiety as they attempt to hold the tic back. The tics will come out and may be more forceful or frequent.

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