Tourette syndrome (TS) is an inherited, neurological disorder characterized by repeated involuntary movements and uncontrollable vocal (phonic) sounds called tics. In a few patients, such tics can include inappropriate words and phrases. It is a fairly common childhood-onset condition that may be associated with features of many other conditions. It occurs in about 1 of every 2000 children. It is more likely to occur in boys, especially if they have a first degree relative that also has this disorder, and usually begins between the ages of 2 and 21 years of age.

Following are some of the symptoms of Tourette's syndrome:

• The first symptoms of TS are usually facial tics--commonly eye blinking. However, facial tics can also include nose twitching or grimaces.
• Consequently other motor tics may appear such as head jerking, neck stretching, foot stamping, or body twisting and bending.
• Both multiple motor and one or more vocal tics are present at some time during the illness, although not necessarily simultaneously.
• Tics occur many times a day nearly every day or intermittently throughout a span of more than one year.
• TS patients may utter strange and unacceptable sounds, words, or phrases. It is not uncommon for a person with Tourette's syndrome to continuously clear his or her throat, cough, sniff, grunt, yelp, bark, or shout.
• There is a significant impairment or marked distress in social, occupational, or other important areas of functioning.
• People with TS may involuntarily shout obscenities (coprolalia) or constantly repeat the words of other people (echolalia). They may touch other people excessively or repeat actions obsessively and unnecessarily. Some of them often display self-destructive behavior.

No blood analysis, x-ray or other medical test exists to identify TS. Diagnosis is made by observing the signs or symptoms as described above. For a diagnosis of TS to be made, both motor and vocal tics must be present for at least 1 year. A doctor may wish to use a CAT scan, EEG, or other tests to rule out other ailments that could be confused with TS. Some medications cause tics, so it is important to inform the professional doing the assessment of any prescribed, over-the-counter, or street drugs to which the patient may have been exposed.

It is not known what causes TS and there is no cure, but symptoms can usually be managed with counseling, accommodations at school and medications, especially if the tics are interfering with school or social interactions. When symptoms interfere with functioning, medication can effectively improve attention span, decrease impulsivity, hyperactivity, tics, and obsessive-compulsive symptomatology. Relaxation techniques and behavior therapy may also be useful for tics, ADD symptoms, and OCD symptoms.

The diagnosis of TS does not mean that the person necessarily needs medication. Sometimes just educating the patient and those around him/her can make a significant difference, as can accommodations or modifications in school or on the job. The condition in many individuals improves as they mature. Individuals with TS can expect to live a normal life span. Although the disorder is generally lifelong and chronic, it is not a degenerative condition. TS on its own does not impair intelligence.

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