Who gets it
Tourette syndrome can affect people of all races and ethnic groups. It's more common in boys than in girls, and it almost always starts before age 18, usually between ages 5 and 7. Even though kids with Tourette syndrome can get better as they get older, many will always have it. The good news is that it won't make them less intelligent or need treatment at a hospital or doctor's office.
Sometimes a person with Tourette syndrome might have other conditions, like attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or trouble learning. There are also lots of people who have other tic disorders who don't have Tourette syndrome.
Types of tics
Coprolalia - using obscene or unacceptable language.
Coprophenomena - the involuntary expression of socially unacceptable words or gestures.
Echophenomena - repeating other people’s words and other people’s gestures.
NOSI - Non-Obscene Socially Inappropriate behaviour, involves saying things that are socially unacceptable.
Paliphenomena - Similar to echophenomena. Involves the person with TS repeating their own words and actions.
Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, shoulder shrugging, and head or shoulder jerking. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia. However, coprolalia is only present in 10 to 15 percent of individuals with TS. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.
There isn't a specific diagnostic test for TS, instead, the doctor diagnoses it after taking a medical history and doing a physical exam. Sometimes, doctors use imaging tests like magnetic resonance imaging tests, computerized tomography scans, electroencephalograms, or blood tests to rule out other conditions that might have symptoms similar to TS.
Just as TS is different for every person, the treatment for it varies, too. While there isn't a cure for TS, sometimes doctors suggest medicines to help control symptoms if they start to interfere with schoolwork or daily life. But most tics do not get in the way of day-to-day life and won't need any medication.
Behavioral therapy is a treatment that teaches people with TS ways to manage their tics. Behavioral therapy is not a cure for tics. However, it can help reduce the number of tics, the severity of tics, the impact of tics, or a combination of all of these. It is important to understand that even though behavioral therapies might help reduce the severity of tics, this does not mean that tics are just psychological or that anyone with tics should be able to control them.
Habit reversal is one of the most studied behavioral interventions for people with tics. It has two main parts: awareness training and competing response training. In the awareness training part, people identify each tic out loud. In the competing response part, people learn to do a new behavior that cannot happen at the same time as the tic. For example, if the person with TS has a tic that involves head rubbing, a new behavior might be for that person to place his or her hands on his or her knees, or to cross his or her arms so that the head rubbing cannot take place.