The first signs of Tourette syndrome usually occur in children between the ages of 7 and 10, but they can begin as early as 2 years or as late as 18. Tics that begin after age 18 are not considered symptoms of Tourette syndrome.
About one-third of children with Tourette syndrome have no tics by the time they reach early adulthood, one-third have fewer and milder tics by the time they become adults, and one-third continue to have severe tics into adulthood.
Some symptoms of Tourette syndrome include:
- Eye blinking
- Nose twitching
- Head jerking
- Shoulder shrugging
- Arm flapping
- Touching things or people
- Throat clearing
- Shouting a word or phrase
- Repeating other people’s words (echolalia)
- Combinations of movements and sounds
While some people with Tourette syndrome may call out obscene or inappropriate words or phrases (coprolalia) or perform obscene gestures (copropraxia), these are rather uncommon behaviors despite their frequent association with the disorder.
The uncontrollable motor and vocal tics can be classified as simple or complex: Simple motor tics involve only one muscle group. Complex ones can be a combination of many simple motor tics or a series of movements that involve more than one muscle group.
In addition to the motor and vocal tics, people with Tourette syndrome may exhibit other symptoms, including:
- Learning difficulties
- Concentration problems
- Behavioral issues, such as aggressive, hostile, irritable and immature behavior
- Attention deficit hyperactivity disorder (ADHD)
- Obsessive-compulsive disorder (OCD)
- Self-harming on purpose
- Anxiety or emotional stress
- Sleep problems, including trouble falling asleep, restlessness during sleep, talking during sleep, sleepwalking or nightmares
The effect Tourette syndrome has on a child’s life varies. Having tics does not affect a child’s intelligence, but the condition may interfere with learning. Some tics may lead to discomfort in social situations.
Causes and Risk Factors
Most people with Tourette syndrome are believed to have a gene that makes them more likely to develop the condition, which is more common in boys. Another theory is that disruption of certain chemicals in the brain responsible for sending nerve impulses may be a factor. A person’s emotional and physical health or external stress may also contribute to the development of Tourette syndrome.