Tourette's Disorder

Tourette's disorder (TD), sometimes called Tourette's syndrome (TS), is a neurological disorder characterized by multiple repeated tics.

The tics are abrupt, purposeless and involuntary vocal sounds or muscular jerks. Symptoms of TD usually begin between the ages of five and 10, and usually begin with mild, simple tics involving the face, head, or arms. With time, tics may become more frequent and increase in variety, involving more body parts, such as the trunk or legs.

Causes and symptoms

Tourette's disorder is an autosomal dominant disorder. Autosomal means that both males and females are affected, and dominant means that one copy of the gene is necessary to have the condition.

This means that a parent with TD or a parent who has the gene for TD has a 50/50 chance, with each pregnancy, to pass the gene on. TD is associated with a nongenetic cause in 10 percent to 15 percent of children. Complications of pregnancy, low birth weight, head trauma, carbon monoxide poisoning and encephalitis are thought to be associated with the onset of nongenetic TD.

Not everyone who inherits the TD gene will exhibit symptoms of the disorder. Males are affected more than females.

A diagnosis of TD is generally made before the age of 18; often, diagnosis is made around the age of seven.

Some common symptoms of TD include:

• Involuntary, purposeless, motor movements (may involve different parts of the body, such as the face, neck, shoulders, trunk, or hands), including head jerking, squinting, blinking, shrugging, nose twitching or grimacing.

• Unusual sounds, such as grunting, moaning, barking, obscenities, throat clearing or hissing.

Many children and adolescents who have TD also have attention problems and some also have academic difficulties. However, most have normal intelligence and do not usually have primary learning disabilities.

Diagnosis and treatment

A diagnosis of Tourette's disorder is usually made by a pediatrician, child psychiatrist or other mental health professional. 

The effect of symptoms on the child's or adolescent's self-concept, family and peer relationships, and classroom participation determines what needs are to be addressed in treatment.

In many cases, TD is not disabling. Development may proceed normally, and there is no need for treatment. However, when tics interfere with functioning or school performance, and/or if there are other disorders also present (such as OCD, or attention deficit/hyperactivity disorder), some effective medications are available.

Children with TD can generally function well at home and in a regular classroom. If they have accompanying emotional or learning problems, they may require special classes, psychotherapy or medication.