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Tourette's syndrome

NHS Direct Online Health Encyclopaedia

Introduction

The full name of the condition is Gilles de la Tourette's Syndrome but it is usually called Tourette's Syndrome or just TS. George Gilles de la Tourette was the doctor who first recognised the symptoms.

TS is known to run in families.  It usually begins in childhood or the teenage years and is caused by problems with the development of the central nervous system (which is made up from the brain and spinal chord).

Early symptoms include repeated twitches, blinks or jerks which are referred to as 'tics'.  In some cases, these may progress to more serious symptoms such as complex physical movements, grunts, coughs, noises or words. However, many people with TS have only mild symptoms which decrease with age. 

It is thought that many mild cases of TS go undiagnosed.

Symptoms

The characteristic symptoms of TS are:

  • physical tics (known as motor tics): Facial twitches, blinking, head and foot movements, mouth movements, other body movements;
  • vocal tics (noises or sometimes words): coughing, throat clearing, snorting, repeating words.

The symptoms often start in childhood (around the age of 7) or early teens and are frequently mild.  In many cases, the symptoms reduce as the child develops into adulthood and may almost disappear.

In a small number of cases, the symptoms get worse and may interfere with day to day life.  Examples of more extreme symptoms include:

  • complex physical movements (jumping, bending / squatting, stamping, kicking, making obscene gestures)
  • Throat noises (barking, snorting, screaming)
  • Words (repeating what other people say, repeating obscene words)

The repeating of obscene words (known as Coprolalia) is rare but is often thought (inaccurately) to be a defining characteristic. Media stereotyping of the condition using this symptom is unhelpful and can be distressing to people with TS and their families.

Causes

The underlying cause of TS is not fully understood.  It is accepted that TS runs in families, but exactly how it is inherited and which genes are involved are not yet known.

TS is known to stem from the development of the brain and spinal chord (the central nervous system) and to involve neurotransmitters (chemicals that carry signals within the brain).  It is possible that some parts of the central nervous system develop unevenly, and that this causes the symptoms of TS.

Diagnosis

A diagnosis is usually made based on the characteristic symptoms and the age at which they appeared. 

However, it is thought that many cases of TS go undiagnosed because the symptoms are very mild and decrease as the child grows up.

Treatment

People with mild TS often do not require any treatment and can learn to live with the symptoms. However, support and advice can often be helpful in this process.

A number of drug treatments are used where the symptoms are more pronounced.  The drugs used will depend on the nature of the tics and how severe they are.  It may be necessary to try several drugs before one is found that suits the person concerned.

People with TS may be referred to a variety of different health care professionals for treatment such as paediatric neurologists and child psychologists. In some hospitals, these specialists work together in a multidisciplinary team to provide the best possible care.

Complications

About half of children who are diagnosed with TS have problems with attention and hyperactivity. 

This can take the form of impulsive behaviour, restlessness, short attention spans, impatience and demanding behaviour.  Although the majority of children may behave like this from time to time,  it can be much more marked in children with TS.

In extreme cases, the symptoms can be very similar to Attention-Deficit Hyperactivity Disorder (ADHD - see separate article).

Without proper support, these problems can interfere with the child's education and social development

© Queen's Printer and Controller of HMSO, 2005

Crown copyright material is reproduced with the permission of the controller of HMSO and the Queens Printer for Scotland.

 

 

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