What Age Do Tourette's Symptoms Begin?

Tourette’s syndrome or disorder is a neurological condition characterized by abrupt involuntary movements and sounds called tics. They generally begin with little tics of the face, head, or arms.

A child may develop several tics that occur more frequently. They may include more bodily parts, such as the trunk or legs.

This condition could interfere with life if the symptoms are severe. All diagnosed with Tourette’s syndrome live a normal life without any effect on their lives or lifespan.

Tics are involuntary, repeated movements and noises, which are extremely difficult for children to control. Tics usually begin as motor tics, followed by vocal tics, and gradually transform into complex tics.

• Motor tics: Abnormal motions of the body and can involve shrugs, jerks, and blinks.
• Vocal tics: Noises produced by the individual. They can involve coughing, sniffing, singing, or screaming words or phrases.
• Simple tics: Involve only a few muscular groups. Actions that come under simple tics involve:
  • Motor
    • Blinking eyes
    • Darting eyes (uncontrolled movements)
    • Throat clearing
    • Head jerking
    • Shoulders shrugging
    • Nose spasms
  • Vocal
    • Barking noise
    • Squealing
    • Clearing of throat
    • Gulping
    • Licking of tongue
• Complex tics: Involve several muscular units that act in a coordinated way, they include:
  • Motor
    • Bending
    • Twisting
    • Jumping
    • Walking in a certain rhythm
    • Self-injurious actions, such as biting or hitting
    • Pulling of clothes
  • Vocal
    • Using socially undesirable words or phrases
    • Echolalia (repeating a sound or a phrase)
    • Palilalia (repeating own words)

The exact of Tourette’s syndrome is unclear. Some probable causes include:

• Genetic predisposition
  • The gene responsible for Tourette’s syndrome could be passed down in families.
  • A child is more prone to developing Tourette’s syndrome if their father, mother, or siblings have the condition.
  • However, not all people with the gene exhibit symptoms.
• Neurological
  • Some studies reported slight flaws in the structure and functioning of the brain in children with Tourette's syndrome.
  • Researchers noted that there could be an issue with one of the brain's neurotransmitters called dopamine.
  • However, detailed specifics are not available regarding these changes.
• Environmental
  • Although not well established, some indications suggest that complications during pregnancy or childbirth may raise a child's chance of acquiring Tourette's syndrome.
  • May involve issues, such as extended labor, significant stress throughout pregnancy, or infants with extremely low birth weight.
  • There could be a link between Tourette's syndrome and a specific streptococcal infection in some children.

A tic is the most common sign of Tourette syndrome. The most common sort of tic is a motor tic, followed by a verbal tic. Tics are worse when the child is excited or stressed, and they improve during focused concentration on a certain activity.

Not all children exhibit severe tics; they may come, fade and resurface. However, Tourette’s is a chronic disease. Tics typically diminish during adolescence and early adulthood. Some people continue to have tics into adulthood.

A person younger than 18 years must have several motor tics and one or more verbal tics for at least one year. Changing frequency and anatomical distribution of tics, a progressive replacement of old symptoms with newer ones, and the absence of alternative medical reasons for the presence of the tics are diagnostic criteria.

The motor and verbal tics may not occur simultaneously or continually, but they should not be caused by medication or other medical disorders.

Doctors may order various blood tests and radiological imaging studies to rule out other possible causes of the symptoms. These radiological tests include:

• MRI scans
• CT scans

Most doctors can readily diagnose persons who exhibit classic Tourette’s symptoms. However, the diagnosis can be difficult in people with unusual symptoms or symptoms that appear later in life. It may take some time before a person is diagnosed with Tourette’s syndrome because many minor tics can be caused by other reasons, such as constant sneezing due to allergies.

Tourette’s syndrome could be associated with the following behavioral disorders:

• Obsessive-compulsive disorder
  • May manifest as counting rituals, compulsive preoccupations, or unpleasant thoughts.
  • Touching an object with one hand and then, touching it with the other to even things out.
  • Continuously checking to ensure that the burner on the stove is turned off.
  • Children frequently repeat a speech or action until it is considered perfect by them.
• Attention deficit disorder or attention deficit hyperactivity disorder
  • A behavioral condition that results in various symptoms in people, including:
    • Difficulty concentrating
    • Easily distracted
    • Failing to complete tasks
    • Acting on impulse
    • Lack of attentiveness
    • Constantly shifting from one activity to another
    • Requiring extensive supervision
    • Being unable to sit still
    • Calling out
    • Lack of self-control
  • Adults may have lingering symptoms, such as impulsive behavior and difficulty concentrating.
  • Dyslexia, arithmetic, and perceptual challenges, and handwriting impairments are examples of learning difficulties.

Other behavioral issues include:

• Compulsive and repeated behaviors
• Concentration problems
• Sleep difficulties
• Depression
• Poor school performance
• Social isolation
• School and social phobia

The most severe behavioral issues include:

• Oppositional or defiant behavior
• Aggression
• Uncooperative behavior

Treatment for Tourette’s syndrome may include psychosocial therapies, medicine, or both. The National Institutes of Health (NIH) reported that there are effective drugs available to treat tics that interfere with everyday living.

• Neuroleptic medications, such as haloperidol and pimozide, can help treat Tourette's syndrome.
• Though some drugs can have adverse effects, they are manageable with the assistance of a doctor.
• However, everyone with Tourette’s syndrome will not require medication to address their disease.

Children who have both attention deficit hyperactivity disorder (ADHD) and Tourette’s syndrome (TS) may benefit from medication. Researchers reported that the combination of the drugs, clonidine, and methylphenidate helped treat ADHD in people with TS. The treatment did not increase the occurrence of tics compared to a placebo.

Behavioral therapies, either alone or in combination with medication, can help. Researchers reported that behavioral therapy has mild to significant therapeutic benefits.

Behavioral therapy is particularly effective when people attend more therapy sessions. Behavioral treatment was more successful in people who did not have ADHD. According to the NIH, psychological therapies could be beneficial for Tourette's because they help manage the illness and any co-occurring mental or emotional health issues.