Tourette's Syndrome

Tourette's syndrome (TS) is an inherited, neurological disorder characterized by multiple involuntary movements and uncontrollable vocalizations called tics that come and go over years. In a few cases, such tics can include inappropriate words and phrases.

The symptoms of TS generally appear before the individual is 18 years old. TS can affect people of all ethnic groups; males are affected 3 to 4 times more often than females. It is estimated that 100,000 Americans have full-blown TS, and that perhaps as many as 1 in 100 show a partial expression of the disorder.

Not all people with TS have disorders other than tics. However, many people experience additional problems such as obsessive compulsive behavior, characterized by an intense need to act repeatedly, such as hand washing or checking that a door is locked; attention deficit-hyperactivity disorder, characterized by difficulty concentrating and staying on task; learning disabilities, which include reading, writing and arithmetic difficulties; or sleep disorders, which include frequent awakenings or talking in one's sleep.

The wide range of behavioral symptoms that can accompany tics may, in fact, be more disabling than the tics themselves. Patients, families and physicians need to determine which set of symptoms is most disabling so that appropriate medications and therapies can be used.

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Generally, TS is diagnosed by obtaining a description of the tics and evaluating family history. For a diagnosis of TS to be made, both motor and phonic tics must be present for at least 1 year. Neuroimaging studies, such as magnetic resonance imaging (MRI), computerized tomography (CT), and electroencephalogram (EEG) scans, or certain blood tests may be used to rule out other conditions that might be confused with TS. However, TS is a clinical diagnosis. There are no blood tests or other laboratory tests that definitively diagnose the disorder.

Studies show that correct diagnosis of TS is frequently delayed after the start of symptoms because many physicians may not be familiar with the disorder. The behavioral symptoms and tics are easily misinterpreted, often causing children with TS to be misunderstood at school, at home, and even in the doctor's office. Parents, relatives, and peers who are unfamiliar with the disorder may incorrectly attribute the tics and other symptoms to psychological problems, thereby increasing the social isolation of those with the disorder. And because tics can wax and wane in severity and can also be suppressed, they are often absent during doctor visits, which further complicates making a diagnosis.

In many cases, parents, relatives, friends or even the patients themselves become aware of the disorder based on information they have heard or read in the popular media.

Tourette's Syndrome. Last reviewed 11/14/2006

Sources:

  • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
  • Revised National Institute of Neurological Disorders and Stroke
  • National Institutes of Health National Institutes of Health - National Library of Medicine