What is Tourette's disorder?
Tourette's disorder is a brain condition that starts in childhood. Children with Tourette's make sounds or movements—such as coughing or twitching—that they can't control. These are called tics.
Tics usually start at about age 2. They may be at their worst by age 12. Tics tend to decrease during teenage years. They can continue into adulthood but occur less often and are less severe than in childhood.
What causes Tourette's disorder?
Tourette's tends to run in families. Other things that may increase the risk include:
- A mother who had severe nausea and vomiting during the first trimester of pregnancy, was under severe stress during her pregnancy, or who drank a lot of coffee, smoked cigarettes, or drank alcohol during her pregnancy.
- Not having enough oxygen or blood supply during birth.
- A low birth weight and signs of brain injury or an enlarged section of the brain.
- A lower birth weight than an identical twin.
What are the symptoms?
Most children with Tourette's have different patterns of tics. The tics may not be obvious. They can be bursts of movement or sounds that last for seconds or minutes.
Tics can include:
- A slight twitching of the eyes.
- Jerking of the neck.
- Coughing or throat-clearing.
- A mix of movements and sounds.
It's common for a person who has Tourette's to feel an urge in some part of the body that builds and builds. This urge can only be relieved by performing the tic. But not everyone with the disorder is aware of these urges.
How is Tourette's disorder diagnosed?
A doctor can diagnose Tourette's based on your child's medical history and symptoms. The doctor may want to know if tics are causing school or social problems for your child.
There are no tests to diagnose Tourette's. But in some cases an electroencephalogram (EEG), an MRI, or blood tests may be done to check for other health problems. Your doctor may also check for attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or other learning or behavior problems. These problems sometimes occur along with Tourette's disorder.
How is it treated?
Treatment for Tourette's disorder focuses on helping your child cope with the tics. Understanding how tics affect your child can help you and your child know what to expect. It may help to identify when tics occur and what is going on in your child's life during those times.
If tics are seriously affecting your child's quality of life at home or school, then counseling, behavioral therapy to reduce tics ( habit reversal), and medicines may help. If your child has other medical problems, these may need to be treated first to see how they affect your child's symptoms.
What can you expect when your child has Tourette's?
Despite what you might have seen in movies or on TV, most people with Tourette's disorder don't have uncontrollable outbursts of cursing or sexual behavior.
As your child ages, the pattern of tics can change. Tics may come and go over weeks and months. They may also change from one kind to another. Tics may get worse and then get better. Your child may get a new tic, or an old one may come back.
Tics may get worse for no reason. Your child may try to suppress tics, which may make them last longer or be worse than at other times. They may also get worse when your child is ill, under stress, or excited.
Having Tourette's doesn't have to mean that your child will have social problems or trouble in school. You can help your child learn to cope with tics. Start by learning more about Tourette's and being supportive at home. Work with your child's teachers so they can understand how tics affect your child.
Other Works Consulted
- Bloch MH, Leckman JF (2008). Tourette disorder and obsessive-compulsive disorder in children and adolescents. In MH Ebert et al., eds., Current Diagnosis and Treatment: Psychiatry, 2nd ed., pp.641–656. New York: McGraw Hill.
- Chadehumbe MA, et al. (2011). Psychopharmacology of tic disorders in children and adolescents. Pediatric Clinics of North America, 58(1): 259–272.
- Fahn S, et al. (2010). Gilles de la Tourette syndrome. In LP Rowland, TA Pedley, eds., Merritt's Neurology, 12th ed., pp. 735–737. Philadelphia: Lippincott Williams and Wilkins.
- Himle MB, et al. (2006). Brief review of habit reversal training for Tourette syndrome. Journal of Child Neurology, 21(8): 719–725.
- Jummani R, Coffey BJ (2009). Tic disorders. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3609–3623. Philadelphia: Lippincott Williams and Wilkins.
- Murphy TK, et al. (2010). The immunobiology of Tourette's disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders: A way forward. Journal of Child and Adolescent Psychopharmacology, 20(4): 317–331.
- Murray BJ (2006). Tourette syndrome. In MR Dambro, ed., Griffith's 5-Minute Clinical Consult, pp. 1132–1133. Philadelphia: Lippincott Williams and Wilkins.
- Piacentini JC, Chang SW (2006). Behavioral treatments for tic suppression: Habit reversal training. Advances in Neurology, 99: 227–233.
- Ropper AH, et al. (2014). Tremor, myoclonus, focal dystonias, and tics. In Adams and Victor's Principles of Neurology, 10th ed., pp. 92–114. York: McGraw-Hill Education.
- Simpson DM, et al. (2008). Assessment: Botulinum neurotoxin for the treatment of movement disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 70(19): 1699–1706.
- Stubbe D (2007). Tourette disorder and other tic disorders. In Child and Adolescent Psychiatry: A Practical Guide, pp. 87–93. Philadelphia: Lippincott Williams and Wilkins.