What Causes Tourette Syndrome?

Tourette syndrome may be caused by genetics and environmental factors such as infections.

The exact cause of Tourette syndrome isn't known. It is likely to be caused by an interplay between genetic and environmental factors such as certain infections.

Recent research on Tourette syndrome has found problems in certain brain regions and neurotransmitters (dopamine, serotonin and norepinephrine) that transmit messages between the nerve cells. These abnormalities may be responsible for the symptoms in Tourette syndrome.

Certain factors that put you at a risk of Tourette syndrome include

• Having a family history of Tourette syndrome or other tic disorders
• Male sex (men are about three to four times more likely than women to develop Tourette syndrome)

Tourette syndrome is a neurological disorder characterized by brief, repetitive, intermittent, involuntary actions known as tics. Tics that involve movement are referred to as motor tics and those that involve sounds are referred to as vocal tics. Motor tics usually show up before vocal tics do.

It is estimated that one out of every 160 children between the ages of 5 to17 years old in the United States is affected by Tourette syndrome. The average onset of symptoms is between the ages of three and nine years.

For doctors to diagnose Tourette syndrome, you should have both motor and vocal tics for at least one year. There is typically no need for any investigations to arrive at the diagnosis of Tourette syndrome. In rare cases, the doctor may order for imaging studies, such as magnetic resonance imaging (MRI) or computerized tomography (CT) and electroencephalogram (EEG) studies that may help them rule out other conditions when symptoms are confusing.

The disorder does not get worse over time and the condition improves in the late teens and early 20s in many patients. Symptoms may disappear in some people.  Others may not need medications to suppress tics. The majority of people with Tourette syndrome require no treatment for tic suppression unless the symptoms interfere with functioning.

Tourette syndrome is generally lifelong and chronic and has no cure. You cannot get rid of it. However, you can get rid of its symptoms and various treatment options can help you to effectively deal with them.

• Neuroleptics: These drugs are used to treat psychotic and non-psychotic disorders. The most effective ones in Tourette syndrome are haloperidol and pimozide.
• Alpha-adrenergic agonists: These drugs used primarily to treat hypertension, for example clonidine and guanfacine, are useful to suppress tics.
• Stimulant medications: For attention-deficit hypersensitivity disorder (ADHD) that occurs in patients with Tourette syndrome, stimulant medications such as methylphenidate and dextroamphetamine are helpful.
• Serotonin reuptake inhibitors: Serotonin reuptake inhibitors such as clomipramine, fluoxetine, fluvoxamine, paroxetine and sertraline have helped in dealing with the obsessive compulsive disorder that accompanies Tourette syndrome.
• Behavioral treatments: Among these, awareness training and competing response training have been used as supportive therapy to reduce tics.