Tourette’s syndrome

Tourette's syndrome is a neurological condition. It makes you produce movements and sounds that you can't control, and these are called tics. A tic is a fast, repetitive muscle movement, and it shows up as a sudden jerk of the body or as a sound.

Tics are the main symptom of Tourette's syndrome, and they come in different types.

Motor tics might include:

• eye blinking
• neck and head jerks
• arm and leg movements
• pinching
• kicking
• hitting
• falling to the ground

Vocal tics might include:

• throat clearing
• grunting
• sniffing
• coughing
• repeating words or phrases
• animal sounds
• stuttering
• singing

Swearing is a rare tic, and it affects only a small number of people with Tourette's syndrome.

• you or your child start having tics

Children often have tics for several months before growing out of them. These are known as transient tics. Having a tic doesn't necessarily mean your child has Tourette's syndrome.

Some people with Tourette's syndrome feel a strong urge before a tic. It's a bit like the feeling you get before you sneeze or need to scratch an itch.

This feeling is called a premonitory sensation, or urge. It only eases after the tic has been carried out.

Premonitory sensations can include:

• a dry or sore throat before grunting
• a burning feeling in the eyes before blinking
• an itchy joint or muscle before jerking

Some people with Tourette's syndrome can hold back their tics for a short while in certain social situations, like in a classroom. This takes concentration and effort, but it can get easier with practice. It's called suppressibility.

Trying to control tics can be tiring. If you've held them back all day at school or work, for example, you might have a sudden, intense release of tics when you get home.

Tics may be less noticeable when you're concentrating on something, like reading a book or playing sports. Sometimes they're more noticeable when you're relaxing.

Tics are not normally harmful, but physical tics can be painful.

Tics can get worse at certain times, and with Tourette's syndrome some things tend to set them off. These include:

• stress
• anxiety
• excitement
• sensory overload
• feeling nervous
• confrontation
• fatigue (tiredness)

Tourette's syndrome often comes with other health conditions, such as:

• attention deficit hyperactivity disorder (ADHD)
• obsessive compulsive disorder (OCD)
• depression or anxiety

No one knows what causes Tourette's syndrome. Doctors also don't know why it affects more males than females. In some families, tics are passed down, so you may find more than one person with them in the same family.

There's no single test for Tourette's syndrome. You might be offered tests and scans, such as an MRI scan, to rule out other conditions. You can be diagnosed with Tourette's syndrome at any age.

Doctors may diagnose it if you've had several movement and sound tics for at least a year, and these started before you turned 18 years of age.

Your doctor might refer you to different specialists to help get a diagnosis, for example a psychiatrist or a neurologist. A neurologist is a doctor who specialises in conditions affecting the brain and nervous system.

Getting a confirmed diagnosis can help you and others understand your condition. It can also allow you to access treatment and support.

There's no cure for Tourette's syndrome. Most children with tics don't need treatment for them. Tics can improve a great deal, or disappear altogether, as people move into their early 20s. But some people find their tics carry on or get worse in adulthood.

Treatment might be recommended to help you control your tics.

Treating other health conditions that go with Tourette's syndrome, like OCD, depression or anxiety, can help improve tics. This includes different types of behavioural therapy that can help reduce tics, such as:

• habit reversal training, which involves identifying the triggers that cause tics and then finding another way of relieving the urge to tic
• exposure with response prevention (ERP), which trains you to control your urge to tic by tolerating the feeling without doing the tic until the urge passes

If your tics are more severe and affect your daily activities, you might benefit from medicine to help treat them.

Medicines for Tourette's syndrome don't help everyone and can cause side effects.