Playing ice hockey is Luke's favorite thing to do. But when Luke has a game someplace new, he often has to deal with stares and weird looks from strangers because he sometimes shouts unexpectedly or blinks his eyes hard. These tics are symptoms of Luke's Tourette syndrome. But to people who don't know him, it looks like he's in pain or needs help.
Tics are sudden, repetitive movements or sounds that some people make, seemingly without realizing it. Tics are actually more common in teens than you might think. You may know someone who has either a motor tic (sudden, apparently uncontrollable movements like exaggerated blinking of the eyes) or a vocal tic (such as frequent, repeated throat clearing).
Many people have tics that go away in less than a year or mild tics that don't interfere with their lives. But in some people, tics are more severe or long lasting.
If a person has tics for more than a year, doctors call this a chronic tic disorder. In some cases, these tics can be part of a condition called Tourette (pronounced: tuh-ret) syndrome, named for the French doctor Georges Gilles de la Tourette, who first described the condition in 1885.
What Is Tourette Syndrome?
Tourette syndrome (TS) is a neurological disorder where a person has both motor and vocal tics. Doctors and scientists don't know the exact cause of TS, but some research suggests that it occurs when there's a problem with how nerves communicate in the brain. A disturbance in the balance in neurotransmitters — chemicals in the brain that carry nerve signals from cell to cell — may play a role in TS.
Tourette syndrome is not contagious. You can't catch it from someone who has it. Studies suggest that TS 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.
As with other genetic disorders, someone may have a tendency to develop TS. But that doesn't mean the person will definitely get the condition. Doctors and researchers are continually learning new information about TS and what might lead a person to develop it.
People with Tourette syndrome usually first notice symptoms while they're kids or teens. TS affects people of all races and backgrounds, although more guys than girls have the condition.
What Are the Signs and Symptoms?
The main symptoms of TS are tics. Motor tics can be everything from eye blinking or grimacing to head jerking or foot stamping. Some examples of verbal tics are throat clearing, making clicking sounds, repeated sniffing, yelping, or shouting. In rare cases, people with TS might have a tic that makes them harm themselves, such as head banging.
At certain times, like when a person is under stress, the tics may become more severe, more frequent, or longer. Or the type of tic may change altogether. (This is also true for people who have tics that are not part of Tourette syndrome.)
Some people may be able to suppress their tics for a short time. But tension builds, and it eventually has to 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 teens with TS to have a conversation or pay attention in class.
In addition, many teens with TS have other conditions, such as attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). Learning disabilities are common in people with TS. They also may have trouble sleeping.
What Do Doctors Do?
Some family doctors may refer a person with symptoms of TS to a neurologist. Before TS can be diagnosed, a person must have multiple motor tics and at least one vocal tic at some time during the illness (though not necessarily at the same time). For doctors to diagnose someone with TS, that person should never have a tic-free period longer than 3 months, even if the tics happen off and on or not every day. The neurologist may ask a person to keep track of the frequency and kinds of tics he or she is having.
There isn't a specific test for TS. Instead, the doctor looks at the family medical history, the person's symptoms, and other clues to make a diagnosis. Sometimes, doctors use imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), 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. There isn't a cure for TS, and no medication can control the disease itself — although some medications can help control tics if they are severe enough to interfere with a person's life.
TS is not a psychological condition, but doctors sometimes refer teens with TS to a psychologist or psychiatrist. Seeing a therapist won't stop tics. But a therapist can help people with TS deal what's going on, cope with stress better, and learn relaxation techniques.
Some research suggests that there might be a connection between strep throat infections and TS, but this is still being studied.
Dealing With Tourette Syndrome
Many people don't understand what TS is or what causes it, so they might not know what to make of someone who has TS. And if people stare, it can feel embarrassing or frustrating. People with TS might have to explain their condition a lot or have to deal with people thinking they're strange. Although it's not easy to have TS, there's good news — the tics usually get milder or go away during adulthood.
In the meantime, if you have TS, it can help to focus your energies on something else. Some of the things teens with TS can do include:
- Get involved. Some people say that when they're engrossed in an activity, their tics are milder and less frequent. Sports, exercise, or hobbies are great ways for teens to focus mental and physical energy. Some well-known athletes have TS.
- Give a helping hand. Dealing with TS often makes people more understanding of other people's feelings, especially other teens with problems. Use your special sensitivity by volunteering.
- Embrace your creativity. Creative activities such as writing, painting, or making music help focus the mind on other things. There's speculation that the composer Mozart had TS.
- Find support. The Tourette Syndrome Association sponsors support groups with others who understand the challenges of TS.
- Take control. People with TS can feel more in control of their lives by researching TS, asking their doctors plenty of questions, and taking an active role in their treatment.
Each person with TS will cope differently with its physical, emotional, and social challenges. Because TS doesn't usually restrict activities, though, people with the condition can enjoy themselves and pursue their dreams and goals in just the same way their friends do.
Reviewed by: Harry S. Abram, MD
Date reviewed: September 2010