https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/the-tic-service/introduction-to-tourette-syndrome/
Introduction to Tourette Syndrome
This page provides some basic facts about Tourette syndrome (TS). It forms part of our TS information pack for young people and families.
What is Tourette Syndrome?
Tourette syndrome (TS) is a neurodevelopmental condition characterised by motor (movement) and vocal (sound) tics. Tics are fast, repetitive muscle movements that result in sudden and difficult-to-control body movements (eye blinking, shoulder shrugging) or sounds (sniffing, throat clearing, involuntary sounds).
Rude words/swearing are perhaps the most well-known sign of TS, but in fact only affect a small number of people with the condition. Tics are common in children of primary school age, and for most young people they are harmless and do not require specialist assessment.
TS diagnosis
Diagnosis is made through observation and history-taking. There are some standards for diagnosing TS that have been agreed internationally. To be diagnosed with TS, a person will have had the following:
- Multiple movement and one (or more) sound tics that happen regularly, although not necessarily at the same time.
- Tics that occurred before the age of 18 years and, on and off, for longer than one year.
- Not have another brain condition that is causing the tics.
There are no specific tests used to diagnose TS so the history of how long and what type of tics your child has experienced will be discussed in detail during the assessment. We may also ask that you show us video recordings of tics, if we do not see them in our appointment.
How common is TS?
TS was first described in the 19th Century by a neurologist, George Gilles de la Tourette, after whom the condition is named. The symptoms can range from mild to severe.
Worldwide, Tourette syndrome is thought to affect about 1% of the general child population. TS affects more boys than girls, and we do not yet know why this is the case. It is also important to note that people from all ethnicities and backgrounds can be affected by Tourette syndrome.
Other conditions
Often, we find that young people diagnosed with TS also present with other co-occurring conditions or difficulties. The conditions associated with TS include:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Obsessive Compulsive Disorder (OCD) and other anxiety disorders
- Social communication difficulties or Autism
- Learning difficulties
- Low Mood
- Anger
These conditions may impact the person with tics even more than the tics themselves. Please see our separate webpages on these conditions.
How is TS treated?
It is important to confirm a diagnosis of TS before treatment starts, to ensure that the treatment is as helpful as possible. Referral in the first instance is usually to a paediatrician (specialist children’s doctor) or to CAMHS (Child and Adolescent Mental Health Service) via the GP.
The most helpful treatment for TS is learning about the condition. Once the young person, their family, friends, and school have a better understanding of tics, they usually cope well, and for many young people no specific treatments are needed.
Behavioural therapies can be helpful to learn strategies to manage tics, or to reduce anxiety and frustration. They can also help to identify triggers and patterns of tics, which mean that these can be better managed.
Specific psychological treatment with cognitive behavioural therapy (CBT) may be useful for obsessive compulsive disorder (OCD) or depression. Psychological approaches can also help the person with tics and family members cope better with the stress of living with tics.
Some of the difficulties that come with TS can be helped with medicine. These include the tics themselves, ADHD, OCD, and sometimes depression. The type and amount of medication varies from person to person.