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Tourette’s Syndrome

Summary

Tourette’s syndrome (TS) is a neurological condition that causes involuntary movements and sounds called tics. It begins in childhood and varies in severity from mild, temporary tics to more complex and persistent ones. Some children may also experience behavioral challenges, including obsessive-compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD).

The exact cause of Tourette’s syndrome is not fully understood, but it often runs in families. There is no specific test to diagnose TS; instead, doctors rely on a detailed medical history and observation of symptoms.

While tics can change in frequency and intensity over time, most children see improvement in their late teens or early adulthood. Managing symptoms involves a combination of education, behavioral strategies, and, in some cases, medication.

Diagnosis and When to Seek Help

A child should be evaluated for Tourette’s syndrome if they exhibit:

  • Repeated involuntary movements (such as blinking, head jerking, or shoulder shrugging)
  • Uncontrollable vocal sounds (such as throat clearing, grunting, or repeating words)
  • Symptoms that persist for more than a year and are not due to another medical condition

A healthcare provider will assess the child’s medical history and symptoms. No laboratory tests are needed, but additional evaluations may be done if another condition is suspected.

Management

Treatment focuses on reducing symptoms that interfere with daily life. Options include:

  • Education and support: Helping children, families, and teachers understand TS can reduce stress and improve coping strategies.
  • Behavioral therapy: Habit reversal therapy (HRT) and cognitive behavioral interventions for tics (CBIT) can help manage symptoms.
  • Medications: In severe cases, medications may be used to control tics or associated conditions like ADHD or OCD.
  • Lifestyle adjustments: Reducing stress, getting enough sleep, and engaging in physical activities can help minimize tic severity.

Follow-Up and Monitoring

Regular follow-ups with a doctor or specialist can help adjust treatment strategies as symptoms change. Emotional support from family, teachers, and peers is essential for a child’s confidence and well-being.

With the right approach, many children with Tourette’s syndrome can lead fulfilling and successful lives. 

History and Exam

Key diagnostic factors

  • Presence of risk factors
  • Early childhood onset
  • Abnormal movements
  • Vocal sounds

Other diagnostic factors

  • Improvement of symptoms when focused on other tasks
  • Worsening of symptoms under stress
  • Ritualistic behaviours

Risk factors

  • Male sex
  • Age 3 to 8 years
  • Family history of TS or tics
  • History of OCD or ADHD

Diagnostic Investigations

1st investigations to order

  • Clinical diagnosis

Investigations to consider

  • Brain MRI
  • EEG
  • Premonitory urge for tics scale (PUTS)

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    Other Related Conditions

    ASTHMA

    CONCERNS REGARDING GROWTH

    FEEDING PROBLEMS

    CONSTIPATION

    BED WETTING

    SEIZURES

    SLEEP DIFFICULTIES

    CHALLENGING BEHAVIOURS

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    ADHD & Oppositional behaviours

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