How to tell if your child has tourettes

Pediatric Tourette Syndrome - Conditions and Treatments

What causes Tourette's disorder?

Tourette's disorder is an autosomal dominant disorder. Autosomal means that both males and females are affected, and dominant means that 1 copy of the gene is necessary to have the condition. This means that a parent with TD or a parent who has the gene for TD has a 50/50 chance, with each pregnancy, to pass the gene on. TD is associated with a nongenetic cause in 10% to 15% of children. Complications of pregnancy, low birth weight, head trauma, carbon monoxide poisoning, and encephalitis are thought to be associated with the onset of nongenetic TD.

Dominant disorders exhibit something known as incomplete penetrance, which means that not everyone with the gene will have symptoms of Tourette's disorder. In other words, if a parent passes the gene on to a child, the child may not have any symptoms of the disorder. If a daughter inherits the gene, there is a 70% chance that she will have at least 1 of the signs of TD. On the other hand, if a son inherits the gene, there is a 99% chance that he will have at least 1 of the signs of TD.

Finally, dominant disorders can also exhibit something known as variable expressivity. This means that there are differences in the expression of the TD gene in different people. For example, 1 person with TD may have obsessive-compulsive disorder, while another has a chronic tic disorder, while another has full-blown TD. In addition, there are differences in expressivity between males and females: males are more likely to have full-blown TD or chronic tics, while females are more likely to have obsessive-compulsive disorder (OCD), an anxiety disorder in which a person has an unreasonable thought, fear, or worry (obsession) that he or she tries to manage through a ritualized activity (compulsion) to reduce the anxiety.

Who is affected by Tourette's disorder?

A diagnosis of TD is generally made before the child reaches his or her 18th birthday. In the majority of cases, a child is diagnosed around the age of 7. TD affects more males than females.

What are the symptoms of Tourette's disorder?

Tic behaviors seen in TD change over time, and vary in frequency and complexity. The following are the most common tic behaviors associated with TD. However, each child experiences symptoms differently. Symptoms may include:

Involuntary, purposeless, motor movements (may involve different parts of the body, such as the face, neck, shoulders, trunk, or hands):
- Head jerking
- Squinting
- Blinking
- Shrugging
- Grimacing
- Nose-twitching
- Any excessively repeated movements (for example, foot tapping, leg jerking, or scratching)

Some of the more complex tic behaviors associated with TD may appear purposeful, and may include the following:

Kissing
Pinching
Sticking out the tongue or lip-smacking
Touching behaviors
Making obscene gestures

In addition to some, or all, of the above symptoms, TD is also characterized by one or more vocal tics (meaningless sound), in order for a diagnosis of TD to be made, including the following:

Grunting or moaning sounds
Barking
Tongue clicking
Sniffing
Hooting
Obscenities
Throat clearing, snorting, or coughing
Squeaking noises
Hissing
Spitting
Whistling
Gurgling
Echoing sounds or phrases repeatedly

Many children and adolescents who have TD also have attention problems and some also have academic difficulties. However, most have normal intelligence and do not usually have primary learning disabilities.

The symptoms of TD may resemble other conditions or medical problems. Always consult your child's healthcare provider for a diagnosis.

Diagnosis Treatments Children's Team Departments

Diagnosis

A pediatrician, child psychiatrist, or a qualified mental health professional usually identifies TD in children and adolescents. A comprehensive evaluation of the child or adolescent's psychological, social, and educational status is recommended, as well as a thorough medical, developmental, and family assessment. A detailed history of the child's behavior from parents and teachers, in addition to observations of the child's behavior, contribute to making the diagnosis.

Treatments

Specific treatment for Tourette's disorder will be determined by your child's health care provider based on:

Your child's age, overall health, and medical history
Extent of disruption caused by tic behavior
Your child's tolerance for specific medications or therapies
Expectations for the course of the disorder

The effect of symptoms on the child's or adolescent's self-concept, family and peer relationships, and classroom participation determines what needs are to be addressed in treatment. In many cases, TD is not disabling. Development may proceed normally, and there is no need for treatment. However, when tics interfere with functioning or school performance, and/or if there are other disorders also present (such as OCD, or attention deficit/hyperactivity disorder), some effective medications are available. Children with TD can generally function well at home and in a regular classroom. If they have accompanying emotional or learning problems, they may require special classes, psychotherapy, and/or medication.

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Tourette Syndrome (for Parents) - Nemours KidsHealth

What Is Tourette Syndrome?

Tourette syndrome is a condition that causes uncontrolled sudden, repetitive muscle movements and sounds known as tics.

Two types of tics are associated with Tourette syndrome:

Motor tics: These are sudden, apparently uncontrollable movements such as exaggerated eye blinking, grimacing, head jerking, or shoulder shrugging.
Vocal tics: These include repeated throat clearing, sniffing, or humming.

Tics can be simple or complex:

Simple motor tics usually involve just one muscle group, such as eye blinking or grimacing.
Complex motor tics usually involve more muscle groups and might look like a series of movements. For example, someone might touch a body part or another person repeatedly. In rare cases, people with Tourette syndrome might have a tic that makes them harm themselves, such as head banging.
Simple vocal tics can be throat clearing, sniffing, or grunting.
Complex vocal tics can involve calling out, repeating other people's words (a condition called echolalia), or involuntary swearing (called coprolalia).

At certain times, like when someone is under stress, the tics can become more severe, happen more often, or last longer. Or the type of tic may change.

Some kids can hold back their tics for a short time. But as tension builds, eventually it must be released as a tic. And if a person is concentrating on controlling the tic, it may be hard to focus on anything else. This can make it hard for kids with Tourette syndrome to have a conversation or pay attention in class.

The tics associated with Tourette syndrome tend to get milder or go away entirely as kids grow into adulthood. Until that happens, though, parents can help their child cope with the condition.

What Causes Tourette Syndrome?

Tourette syndrome is a genetic disorder, which means it's the result of a change in genes that's either inherited (passed on from parent to child) or happens during development in the womb. Tourette symptoms typically appear in childhood, usually when kids are between 5–9 years old. It's not very common, and boys are more likely to be affected than girls.

The exact cause of Tourette syndrome isn't known, but some research points to changes in the brain and problems with how nerve cells communicate. An upset in the balance of neurotransmitters (chemicals in the brain that carry nerve signals from cell to cell) might play a role.

Many kids and teens with Tourette syndrome have other behavioral conditions like ADHD, obsessive-compulsive disorder (OCD), learning problems, or anxiety.

How Is Tourette Syndrome Diagnosed?

To be diagnosed with Tourette syndrome, a child must have several different types of tics — specifically, multiple motor tics and at least one vocal tic for at least a year. They may happen every day or from time to time throughout the year.

A child with Tourette symptoms may need to see a neurologist, a doctor who specializes in problems with the nervous system. The neurologist may ask the child's parents to keep track of the kinds of tics involved and how often they happen.

There isn't a specific diagnostic test for Tourette syndrome. Instead, the health care provider diagnoses it after taking a family history, medical history, looking at the symptoms, and doing an exam. Sometimes, imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests can rule out other conditions that might cause symptoms similar to Tourette syndrome.

How Is Tourette Syndrome Treated?

Just as Tourette syndrome is different for every person, treatment can be different too. There isn't a cure for Tourette syndrome, but most tics don't get in the way of day-to-day life. If they do, doctors may suggest medicines to help control symptoms.

Tourette syndrome is not a psychological condition, but doctors sometimes refer kids and teens to a psychologist or psychiatrist. Seeing a therapist won't stop the tics, but it can help to talk to someone about their problems, cope with stress better, and learn relaxation techniques. A therapist also can help them with any other problems, like ADHD, OCD, and/or anxiety.

Tics usually are most severe before the mid-teen years. Most people see great improvement in their late teens to early adulthood, though some will have their tics continue into adulthood.

What Else Should I Know?

Many people don't understand what Tourette syndrome is or what causes it, so they might not know how to act around someone who has tics. If people stare or comment, kids and teens can feel embarrassed and frustrated. Someone who has it might have to explain the condition to others or deal with teasing or gawking.

These tips can help kids with Tourette syndrome cope:

Get involved. Some experts say that when kids and teens are focused on an activity, their tics are milder and less frequent. Sports, exercise, or hobbies are great ways for kids to focus mental and physical energy.
Lend a helping hand. Dealing with Tourette syndrome often makes kids and teens more understanding of other people's feelings, especially other young people with problems. They might use that special sensitivity to volunteer. Knowing that they've helped others might help build confidence and ease any self-consciousness about feeling different.
Embrace creativity. Creative activities such as writing, painting, or making music help focus the mind on other things — and they help it develop.
Find support. The Tourette Syndrome Association sponsors support groups with others who understand the condition's challenges.
Take control. People with Tourette syndrome can feel more in control of their lives by researching the condition, asking their doctors plenty of questions, and taking an active role in their treatment.

Each person with Tourette syndrome will cope differently with its physical, emotional, and social challenges. Tourette syndrome doesn't have to disrupt everyday life, though, and kids who have it can enjoy doing the same things as other kids.

Reviewed by: Shirin Hasan, MD

Date reviewed: June 2020

Tourette's syndrome - what kind of disease is it

Contents of the article

Factors that provoke Tourette's syndrome
How Tourette's Syndrome Manifests
Disease stages
How is Tourette's syndrome treated in Moscow
Traditional medicine
Tourette Syndrome FAQ

Tourette's syndrome is a genetic disease that is most often passed from fathers to sons, it is much less common in women. At the same time, women whose fathers suffered from this ailment are strongly prone to obsessive-compulsive disorder.

in a tenth of cases, Tourette's syndrome is also accompanied by coprolalia - this is a painful craving for obscene language, a desire to use swear words when it is inappropriate. Coprolalia is not a symptom of this syndrome exclusively, because such a problem occurs in schizophrenia and in some manic states. nine0003

It cannot be said that the disease itself is very rare - it occurs from 1 to 10 times per 2000 people, most often the diagnosis is made in childhood.

Factors provoking Tourette syndrome

Although the disease is genetic, some factors provoke it more actively. Therefore, we single out such causes of Tourette's syndrome:

serious infections;
poisoning with toxins; nine0006
mental injury;
severe and repetitive stress;
use of psychotropic substances (including misuse of prescribed drugs).

How does Tourette syndrome manifest itself

Symptoms of Tourette's syndrome include:

various involuntary tics. Twitching is observed on the neck, face, in the shoulder area;
chaotic and frequent movements of the tongue, lips. Moreover, this may be accompanied by shouting out different words, sounds; nine0006
repetition of individual movements several times, repetition of syllables, words or sounds.

The list shows that the manifestations of the disease are motor (associated with movements) and vocal (associated with sounds). Everything related to movement most often manifests itself from 2 to 8 years old, and vocal “bursts” are also characteristic of younger children.

Any tics in this disease are not controlled. These signs of Tourette's syndrome exist as if by themselves - the patient is unable to cope with them. At the same time, in a stressful situation, such reactions become aggravated, become more pronounced, vivid and frequent. In conditions of complete rest and relaxation, tics are much less disturbing. nine0003

Disease stages

The syndrome has four stages. They are determined depending on how often tics occur. If not more than once a minute - we are talking about the first stage. Moreover, the patient often feels that the problem is approaching, and can somehow disguise it. The second stage is 2 to 4 ticks per minute. This gives a strong tension on the psyche, it is overexcited.

Further, the process goes on increasing: in the third stage, 5 or more ticks per minute are observed, and the fourth is characterized by very frequent ticks. In the latter case, serious mental disorders are not uncommon, since the central nervous system is in constant tension. nine0003

How does Tourette syndrome progress, is there a treatment

It is impossible to completely cure the disease with the help of specific programs, but often it can disappear on its own. For example, this happens during puberty. If Tourette's syndrome persists with age, it often overlaps with various mental disorders such as panic attacks. This syndrome does not carry life-threatening consequences, however, it worsens the patient's quality of life - if only for the reason that the sick person feels uncomfortable, cannot communicate with others like an ordinary person. nine0003

Treatment of Tourette's syndrome involves smoothing out severe symptoms, improving the patient's quality of life.

Diagnostic features

Diagnosis of Tourette's syndrome consists in a set of measures:

interview of the patient, his visual examination;
CT scan of the brain;
MRI. The choice of a specific research method is made by the doctor.

The problem of this nature is dealt with by psychiatrists, and the syndrome itself belongs to psychiatric diseases according to ICD-10.

Important! Parents will not be able to determine for themselves what kind of syndrome a child has. The fact is that there are very dangerous conditions that disguise themselves as tics, so visually they look the same as Tourette's syndrome. But only a professional can verify this. If during the examination the specialist suspects a deviation, he may prescribe a number of additional examinations and analyzes (according to the situation). In this case, it is necessary to go through all the procedures and make sure the diagnosis is accurate. nine0003

How is Tourette's syndrome treated in Moscow

All methods that are used in the treatment of such diseases can be divided into drug and non-drug. The former involve taking sedatives, rarely tranquilizers. If they are prescribed, then in short courses and only after the doctor finds out that this is necessary.

Non-drug treatments for Tourette's syndrome:

relaxing massage - manual and hardware;
reflexology. The option is chosen depending on the situation. Such therapy is carried out with the help of hands, special needles, electrical impulses. The point is to act on certain points of the body, which will help to relax, stabilize the nervous system;
aromatherapy. It aims to rest, calm, relax. After consultation with a doctor, aromatherapy is also available at home - this is a simple and often effective method; nine0006
therapeutic sleep (electrosleep). Thanks to current pulses through special devices, such a dream normalizes the functioning of the brain and central nervous system. It usually lasts from 30 minutes to 2 hours;
psychotherapy. It helps a person get rid of anxiety, complex conditions, psychological trauma, and also teaches you to accept your condition.

An important point in the treatment of Tourette's syndrome is the right environment at home, among close friends. A person with such a deviation should receive support, care, he must be protected from ridicule and inadequate reactions to tics. nine0003

Traditional medicine

With such an ailment, you can use folk remedies that are aimed at stabilizing the condition, maintaining calm. These are teas and tinctures from herbs such as mint, chamomile, lemon balm. You can use any soothing fees if there is no allergy to the components. However, you should not rely on their healing properties - it's just easy support for the condition in addition to the main treatment (be sure to consult with your doctor). nine0003

Tourette's syndrome: questions and answers

Frequently asked questions answered by:

Chudinskaya

Galina Nikolaevna

Experience 30 years

Neurologist

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Why is the syndrome so called?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association of Interdisciplinary Medicine

It takes its name from Gilles de la Tourette. This physician published a major report on 9 patients with this syndrome in 1885.

Who is more likely to suffer from Tourette's syndrome?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association of Interdisciplinary Medicine

Symptoms of Tourette's syndrome are more common in men - 3-4 times more often than in women (according to various sources). Also, the syndrome is more inherent in children - half of the patients get rid of it by the age of 18 (spontaneously). nine0003

How dangerous is Tourette syndrome?

Chudinskaya Galina Nikolaevna

Neurologist, member of the Association of Interdisciplinary Medicine

There is no direct danger to the life and health of the patient or others. It all comes down to the fact that because of the awkwardness and difficulty in communication, the sick person begins to withdraw into himself, to avoid people. Psychotherapy and competent treatment help to resolve this issue. Pr

Tics and Tourette syndrome

Science

Tourette's syndrome - a disease of the nervous system, characterized by the presence of motor and psycho-emotional disorders.

Movement disorders are manifested by the presence of complex tics - involuntary fast, irregular movements or vocalizations. Tourette syndrome includes both motor (eg, eye blinking, shrugging, touching objects, head tilting back) and vocal (eg, coughing, whistling, repeating words) tics.

An important difference between tics and other movement disorders is the ability to temporarily suppress it, although this is accompanied by an increase in internal tension. In addition, tics may be preceded by a feeling of an overwhelming urge to move, which may give the impression that it is voluntary. nine0003

Tics are aggravated by anxiety, agitation, lack of sleep, stress and decrease by strenuous activities that are exciting for a person.

As a rule, tics begin in childhood, are most pronounced during adolescence, and then decrease. In about 1/3 of patients with the onset of adulthood, tics may completely disappear, however, in another 1/3 of cases, the severity of tics may not decrease even in adulthood.

In addition to tics, patients are also concerned about psycho-emotional disorders. It can be an obsessive-compulsive syndrome, a syndrome of impaired attention and hyperactivity, irritability, anxiety, etc. Sometimes such disorders can disable more than the tics themselves. nine0003

I have tics, does that mean I have Tourette's?
No. Not all people with tics have Tourette's syndrome. These can be either motor or vocal tics outside of Tourette's syndrome, or other conditions in which tics are only one of the manifestations.

In order to determine the cause of tics, a specialist consultation is necessary. He will be able to suggest whether your symptoms are really a manifestation of a particular disease and, if necessary, prescribe additional diagnostic procedures. nine0003

What are the treatment options?
It is impossible to completely cure the disease. But there is a therapy that can improve the psycho-emotional state and reduce movement disorders. The severity of tics in this disease, as well as how much they interfere with daily life, varies greatly from case to case. Therefore, therapy is always individual. With mild manifestations of the disease, psychotherapy is recommended, drug treatment is prescribed only with a greater severity of symptoms.