Tourette syndrome is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement tics and at least one vocal tic.
Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency.
Tourette’s is at the more severe end of a spectrum of tic disorders. The tics often go unnoticed by casual observers.
Tourette syndrome was named by French neurologist Jean-Martin Charcot for his intern, Georges Gilles de la Tourette, who published in 1885 an account of nine patients with a “convulsive tic disorder”.
Tourette’s was once regarded as a rare and bizarre syndrome and has popularly been associated with coprolalia (the utterance of obscene words or socially inappropriate and derogatory remarks).
It is no longer considered rare; about 1% of school-age children and adolescents are estimated to have Tourette’s, and coprolalia occurs only in a minority.
There are no specific tests for diagnosing Tourette’s; it is not always correctly identified, because most cases are mild, and the severity of tics decreases for most children as they pass through adolescence.
Therefore, many go undiagnosed or may never seek medical attention. Extreme Tourette’s in adulthood, though sensationalized in the media, is rare, but for a small minority, severely debilitating tics can persist into adulthood. Tourette’s does not affect intelligence or life expectancy.
There is no cure for Tourette’s and no single most effective medication. In most cases, medication for tics is not necessary, and behavioral therapies are the first-line treatment. Education is an important part of any treatment plan, and explanation alone often provides sufficient reassurance that no other treatment is necessary.
Among those who are referred to specialty clinics, other conditions like attention deficit hyperactivity disorder and obsessive–compulsive disorder are more likely than in the broader population of persons with Tourette’s.
These co-occurring diagnoses often cause more impairment to the individual than the tics; hence it is important to correctly distinguish co-occurring conditions and treat them.
While the exact cause is unknown, it is believed to involve a combination of genetic and environmental factors. The mechanism appears to involve dysfunction in neural circuits between the basal ganglia and related structures in the brain.