TouretteSyndrom

Tourettesyndrom, also known as Tourette syndrome, is a neurological disorder defined by the presence of multiple motor tics and at least one vocal tic. The tics typically begin in childhood and vary in type, intensity, and frequency over time. Many individuals experience a premonitory urge—a sensory sensation that precedes the tic and is relieved by performing the tic.

In most cases, tics are gradual and fluctuate in response to stress, fatigue, illness, or excitement. Motor tics may involve the face, neck, or shoulders, while vocal tics can include throat clearing, grunting, or words and phrases. Tics are not intentional and are often out of the person’s control.

Causes are not fully understood, but Tourette syndrome is believed to involve genetic and neurobiological factors affecting brain circuits that regulate movement and behavior. The condition is relatively common, with estimates of about 0.3% to 0.9% of people affected.

Diagnosis is clinical and based on history and observation. Criteria include onset before age 18 and motor plus vocal tics present for more than one year, with symptoms not explained by another condition. Because TS often co-occurs with autism spectrum traits, attention-deficit/hyperactivity disorder, and obsessive-compulsive disorder, evaluation for comorbidities is important.

Treatment focuses on reducing impairment and improving quality of life. Many cases require no medication. Behavioral therapy, such as comprehensive behavioral intervention for tics (CBIT), is effective. When needed, medications including antipsychotics (e.g., risperidone, aripiprazole) or alpha-2 adrenergic agonists (guanfacine, clonidine) may help. Botulinum toxin injections can target focal tics, and deep brain stimulation may be considered in severe, refractory cases.

Prognosis varies; tics commonly decrease in adolescence, though some individuals have persistent symptoms. Education, psychotherapy, and social support are important for reducing stigma and improving functioning.