Gilles de la Tourette syndrome

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Tourette syndrome

Most affected people first notice symptoms of Tourette syndrome during childhood, between ages 7 and 10.

Symptoms of Tourette syndrome can range from almost unnoticeable minor movements (such as grunts, sniffling, or coughing) to continuing, uncontrollable movements and sounds (vocalizations).

The symptoms tend to get better and worse. Symptoms usually get worse before the mid-teen years.

The most common first symptom is a facial tic. Other tics may follow. A tic is a sudden, rapid, repeated movement or voice sound (vocalization). Tics can include:

• Arm thrusting
• Eye blinking
• Jumping
• Kicking
• Repeated throat clearing or sniffing
• Shoulder shrugging

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Tics may occur many times a day, but they tend to improve or get worse at different times. The tics may change with time.

Contrary to popular belief, use of curse words or other inappropriate words or phrases (coprolalia) occurs in only a small number of patients.

Many patients say that the tics are not totally out of their control (involuntary), but that "things just would not feel right" if they did not do them. This is what makes Tourette syndrome different from obsessive-compulsive disorder (OCD) -- people with OCD feel as though they have to do the behaviors.

Many people with the disorder can suppress the tic for periods of time, but find that when it is allowed to occur after that time, it is more dramatic for a few minutes.

There are no lab tests to diagnose Tourette syndrome. However, a health care provider should do an examination to rule out other causes of these symptoms.

To be diagnosed with Tourette syndrome, a person must:

• Have had many motor tics and one or more vocal tics at some time, although not necessarily at the same time
• Have tics that occur many times a day, nearly every day or on and off, for a period of more than 1 year; during this period, there must not be a tic-free period of more than 3 months in a row
• Have started the tics before age 18
• Have no other brain problem that could be a likely cause of the symptoms

Review Date: 03/30/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).