Tourette Syndrome
What is Tourette syndrome?
Tourette syndrome (TS) is a neurological disorder
characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.
The early symptoms of Tourette syndrome are almost always noticed first in childhood, with the average
onset between the ages
of 7 and 10 years. Tourette syndrome occurs in people from all ethnic groups; males are
affected about three to four times more often than females. It is estimated that
200,000 Americans have the most severe form of Tourette syndrome, and as many as one in 100
exhibit milder and less complex symptoms such as chronic motor or vocal tics or transient tics of childhood. Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early
teens, with improvement
occurring in the late teens and continuing into adulthood.
What are the symptoms of Tourette syndrome?
Tics are classified as either simple or complex.
Simple tics
Simple
motor tics are sudden, brief, repetitive movements that involve a limited number
of muscle groups. Some of the more common simple tics include eye blinking and
other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds.
Complex tics
Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering swear words) or echolalia (repeating
the words or phrases of others). Some tics are preceded by an urge or sensation
in the affected muscle group, commonly called a premonitory urge.
Some with Tourette syndrome will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
Tics are often worse with excitement or
anxiety and better during calm, focused activities. Certain physical experiences can
trigger or worsen
tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during
sleep but are often
significantly diminished.
What is the course of Tourette syndrome?
Tics come and go over time, varying in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include muscles of the trunk and extremities. Motor tics generally precede the development of vocal tics and simple tics often precede complex tics. Most patients experience peak tic severity before the mid-teen years with improvement for the majority of patients in the late teen years and early adulthood. Approximately 10 percent of those affected have a progressive or disabling course that lasts into adulthood.
Next: Can people with Tourette syndrome control their tics? »
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