Overview
Tourette syndrome (TS) is a neurodevelopmental disorder that is characterized by sudden, involuntary, repetitive, and rapid muscle movements or vocal sounds called “tics”. Tics will often improve significantly or even disappear entirely after a few years. However, some people with TS may have tics into adulthood. In more severe cases, tics can cause difficulties at school or in other social settings if left untreated. Symptoms for this disorder usually begin between the ages of 5 and 10.
Symptoms
Tics are the main symptoms of TS. There are two types of tics (motor and vocal) and both are classified as either simple or complex. These symptoms range from mild to severe. Although most cases are mild, more severe tics may interfere with daily functioning and social interactions.
Motor Tics
Motor tics involve body movements such as eye blinking, facial grimacing, shoulder shrugging, or head jerking.
Vocal Tics
Vocal tics are sounds made unintentionally. Examples of vocal tics are humming, tongue clicking, throat clearing, or grunting.
Simple Tics
Simple tics are sudden, brief, or repetitive movements that involve a limited number of muscle groups.1
Complex Tics
Complex tics involve several muscle groups with distinct, coordinated patterns of movements.
Commons tics in TS
| Motor Tics | Vocal Tics | |
| Simple | Eye blinking | Throat clearing |
| Grimacing | Grunting | |
| Shoulder shrugging | Coughing | |
| Should jerking | Sniffing | |
| Head jerking | Barking | |
| Complex | Any combination of the simple motor tics | Repeating others’ words or phrases(echolalia) |
| Hopping or Jumping | Repeating one’s own words or phrase | |
| Repeating observed movements | Using obscene or swear words (coprolalia) | |
| Obscene gesturing | ||
| Twisting |
Most people with Tourette Syndrome experience a strong urge or sensation in the affected muscle groups before a tic. To relieve the urge, the tic needs to be expressed. This is called a premonitory urge or sensation. Some people can suppress their tics for a short time, but with great effort.
Tics are better during quiet and focused activities. They worsen when the person with TS is tired, stressed, anxious, or excited. Certain physical sensations can trigger tics. For example, tight collars may cause neck tics. The environment can also play a role at times. Hearing others sniff or clear the throat may set off vocal tics with similar sounds.
Cause
The exact cause of Tourette Syndrome is unknown. Research shows it is a complex disorder caused by the interplay of genetics and environmental factors. Genetic studies show that having a family history of TS or other tic disorders may increase the risk of developing this disorder. For reasons unknown, males are three times more likely than females to have TS.2
Find out more about the causes and risk factors of Tourette Syndrome
Associated Disorders
Tourette Syndrome often occurs with other neurobehavioral conditions. These co-occurring disorders often result in more impairment than the tics themselves.
The most common associated conditions are:3
- Attention Deficit Hyperactivity Disorder (ADHD)
- Obsessive Compulsive Disorder (OCD)
- Anxiety
- Learning Disabilities
- Behavioral Problem
- Intellectual Disabilities
- Developmental Delays
- Speech or Language Impairment
- Sensory Processing Issues
Find out more about other conditions
Diagnosis
There is no single medical test to diagnose this disorder. The diagnostic criteria based on the Diagnostic and Statistical Manual of Mental Disoders_DSM-5 are:4
- Multiple motor and/or one or more vocal tics have been present at some time during the illness, although not necessarily concurrent.
- The tics may wax and wane in frequency but have persisted for more than 1 year since the first tic onset.
- Onset is before age 18 years.
- The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington’s disease, postviral encephalitis).
Find out more about the diagnosis of TS and other tic disorders
Treatment
Although there is no cure for Tourette Syndrome, proper treatments can help manage symptoms. Many individuals with TS who have mild symptoms do not require treatment. For those with more severe symptoms that interfere with daily function, both medication and behavioral therapy are effective in managing those symptoms.
Find out more about the TS treatment
For More Information
National Institute of Neurological Disorders and Strokes (NINDS)
NIH RePORTER: A searchable database of current and past research supported by the National Institutes of Health (NIH) and other federal agencies
Tourette Association of America
Centers for Disease Control and Prevention
1 Tourette Syndrome Fact Sheet | National Institute of Neurological Disorders and Stroke. (n.d.). Retrieved June 22, 2022, from https://www.ninds.nih.gov/health-information/patient-caregiver-education/fact-sheets/tourette-syndrome-fact-sheet
2 CDC. (2022, May 5). Data and Statistics on Tourette Syndrome | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/tourette/data.html
3 Tourette Syndrome Fact Sheet | National Institute of Neurological Disorders and Stroke. (n.d.). Retrieved June 20, 2022, from https://www.ninds.nih.gov/health-information/patient-caregiver-education/fact-sheets/tourette-syndrome-fact-sheet
4 American Psychiatric Association, & American Psychiatric Association (Eds.). (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed). American Psychiatric Association.