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What Are the Causes of Tourette Syndrome?

Tourette syndrome is a disorder that causes involuntary, repetitive movements and vocalizations, called “tics.” The cause of Tourette syndrome is not known, but it does tend to run in families. Environmental, developmental, and other factors are potential causes as well.
Tourette syndrome is a disorder that causes involuntary, repetitive movements and vocalizations, called “tics.” The cause of Tourette syndrome is not known, but it does tend to run in families. Environmental, developmental, and other factors are potential causes as well.

Tourette syndrome, also called Tourette’s disorder, is a type of tic disorder characterized by involuntary, repetitive movements and vocalizations, called “tics.” 

The cause of Tourette syndrome is unknown. Genetics play a role, and the condition tends to run in families. 

Environmental, developmental, and other factors may also be causes.

What Are Symptoms of Tourette Syndrome?

Symptoms of Tourette syndrome include:

Motor tics, which are tics that involve sudden unusual movements, for example:

  • Eye blinking
  • Facial grimacing
  • Jaw movements
  • Shoulder shrugging 
  • Head jerking or bobbing
  • Neck stretching
  • Walking strangely
  • Kicking, jumping, hopping, twirling, or moving the body in odd ways
  • Scratching
  • Arm jerking
  • Making obscene gestures
  • Vocal/phonic tics, which are tics that involve unusual sounds or words, or phrases that don't make sense or seem unusual, for example:
  • Throat-clearing
  • Grunting
  • Sniffing
  • Hooting
  • Shouting
  • Other noises
  • Inappropriate words (swearing, ethnic slurs, or other socially unacceptable words or phrases)
  • Repetition of words or phrases (including echoing what other people say)

Tourette syndrome is commonly accompanied by other neurodevelopmental and neuropsychiatric conditions, such as:

  • Attention Deficit Hyperactivity Disorder (ADHD) 
  • Obsessive-Compulsive Disorder (OCD) 
  • Learning difficulties 
  • Behavior problems 
  • Anxiety 
  • Mood problems 
  • Deficits in social skills and social functioning 
  • Sleep problems 

How Is Tourette Syndrome Diagnosed?

There is no laboratory test used to diagnose Tourette syndrome and a physical examination usually will not reveal anything abnormal. Testing may be indicated to rule out other conditions.

Diagnostic criteria used to diagnose Tourette syndrome may include: 

  • At least 2 motor tics and at least 1 vocal (phonic) tic have occurred, not necessarily at the same time
  • Tics may come and go in frequency but have been happening for more than 1 year
  • Tics started to appear before the age of 18
  • Tics are not caused by the use of a substance or other medical condition

What Is the Treatment for Tourette Syndrome?

If tics are mild, treatment for Tourette syndrome may not be needed. If tics start to interfere with a person’s life or cause pain or injury, treatment may be indicated. 

Treatments for Tourette syndrome include:

  • Medications
    • Haloperidol (Haldol)
    • Pimozide (Orap)
    • Aripiprazole (Abilify) 
    • Botulinum toxin (Botox)
    • “Off-label” medications (not FDA approved for treatment of tics) 
      • Guanfacine 
      • Clonidine
    • Medications for co-occurring conditions
      • Stimulant medications or non-stimulant medications, such as guanfacine, clonidine, and atomoxetine for ADHD
      • Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, sertraline, and fluvoxamine, for anxiety/OCD
  • Deep brain stimulation (DBS)
    • Behavior modification 
    • Comprehensive behavioral intervention for tics (CBIT)
  • Habit reversal training
  • Speech therapy

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References
https://www.uptodate.com/contents/tourette-syndrome-the-basics?search=Tourette%27s%20Syndrome&source=search_result&selectedTitle=1~81&usage_type=default&display_rank=1

https://tourette.org