Tourette Syndrome

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KEY POINTS

• Tourette syndrome is a disorder that causes your child to make sounds and brief, rapid movements of his face, hands, or legs that he cannot control. This happens over and over.
• Tourette syndrome can be treated with different therapies to learn how to control the tics. It is also sometimes treated with medicine.

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What is Tourette syndrome?

Tourette syndrome (TS) is a disorder that causes both motor and vocal tics. Motor tics are brief, rapid movements of the face, hands, or legs that happen over and over. Vocal tics can be words, throat clearing, or other sounds that are not made on purpose.

If tics are severe, or happen often, they can affect your child's life in many ways.

Tourette syndrome is usually lifelong, though symptoms may improve for weeks or even years at a time. In most cases, the symptoms get better in adulthood.

What is the cause?

The exact cause of this disorder is not known.

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way your child thinks, feels, or acts. Children with this disorder may have too little or too much of some of these chemicals.
• People with this disorder may have physical changes in their brain. These changes may mean that some parts of the brain are more active or less active than in other people.
• Stress also plays a part.
• TS tends to run in families.

What are the symptoms?

Symptoms may include:

• Eye twitches or eye blinks
• Facial grimaces
• Head jerks
• Kicking, jumping, bending, or twisting
• Touching objects
• Grunting, throat clearing, or sniffling
• Yelping, making up words, or repeating words over and over. The words may be swear words or other unacceptable words, which can be very embarrassing at work or at school.

Your child may have one type of tic or many different tics. The tic may start in one body part and spread to other body parts. Sometimes tics disappear for minutes or hours.

Many children with TS also have

• Attention deficit hyperactivity disorder (ADHD), which causes problems paying attention, trouble sitting still, and doing things without thinking first
• Obsessive compulsive disorder (OCD), in which your child constantly thinks about something that causes anxiety, or does certain actions over and over to help control anxiety, such as checking, counting, or repeating words
• Depression, which is feeling sad, hopeless, and uninterested in daily life
• Anxiety, which is feel tense and nervous much of the time

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child may have tests or scans to check for possible causes of his symptoms.

How is it treated?

TS may be treated with several kinds of medicine. Comprehensive Behavioral Intervention for Tics (CBIT), which includes habit reversal training and other therapies, may also help. With habit reversal training, your child does something instead of the tic. The new action should use muscles in a way that makes it impossible to do the old habit. For example, instead of an eye blink tic, your child could very gently close his eyelids and hold them closed for 10 seconds.

Usually your child will have more tics when he is tense or stressed and fewer tics when he is asleep, relaxed, or focused on an absorbing task. The use of relaxation techniques or biofeedback may help relieve stress and reduce tics.

How can I help take care of my child?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take care of your child’s health. Make sure your child eats a healthy diet and gets enough sleep and exercise every day. Teach your child to avoid alcohol, caffeine, nicotine, marijuana, and other drugs.
• Help your child learn to manage stress. Teach your child to practice deep breathing or other relaxation techniques when feeling stressed. Help your child find ways to relax. For example, your child may take up a hobby, listen to music, play, watch movies, or take walks.
• Never punish or shame a child for tic behaviors. There is very little that your child can do to control or stop the tics. Telling your child to stop does not solve the problem. In fact, it may make tics worse. Don’t make a big deal out of the behavior.
• Join a support group. Support groups can help by sharing common concerns and solutions to problems with others in the same situation. You can find these services through your healthcare provider, schools, therapy programs, and local and national support organizations.

Ask your provider:

• How and when you will get your child’s test results
• If there are activities your child should avoid and when he can return to his normal activities
• How to take care of your child at home

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

You can get more information from:

• The Tourette Syndrome Association, Inc.
  718-224-2999
  https://www.tourette.org