Tourette Syndrome – Diagnosis and Treatment
Diagnosing Tourette’s and Related Tic Conditions
Doctors diagnose Tourette’s syndrome and other tic disorders by using clinical criteria. There is no specific laboratory test for these conditions.
Health professionals review the person’s history and look for motor tics (like blinking or head movements) and vocal tics (such as grunting or throat clearing). Both types of tics need to be present, but not always at the same time.
Key Points Used to Diagnose Tourette’s:
- Tics start before age 18.
- Tics occur almost daily or off and on for more than a year.
- Both motor and vocal tics appear at some point.
- Tics are not caused by medication or another health condition.
- The pattern, location, or type of tics can change over time.
Doctors often use blood tests or imaging studies like MRI scans to rule out other causes. Some conditions, such as OCD, ADHD, or learning difficulties, can also appear with Tourette’s and affect diagnosis and treatment.
Types of Tics
| Type | Description |
|---|---|
| Simple Tics | Quick, repeated movements or sounds |
| Complex Tics | Slower, more purposeful actions or phrases |
Doctors also check for behavior problems or learning disabilities. These issues can affect how they manage the movement disorder.
Treatment
Medicines Used for Tics
Doctors use several types of medicine to help manage Tourette syndrome. Medicine does not cure tics, but it can make them less frequent or less severe.
Some medications act as dopamine receptor blocking agents (antipsychotics) to block or reduce dopamine, a brain chemical linked to tics. These medicines may help reduce tics but can cause side effects like weight gain and involuntary movements (tardive dyskinesia).
Doctors may use vesicular monoamine transporter 2 (VMAT2) inhibitors to help control tics, though these drugs may increase the risk of depression in some individuals.
For tics affecting a specific muscle group or for vocal tics, doctors sometimes recommend a neuromuscular blocking agent (botulinum toxin injection). This treatment helps relax the targeted muscles and reduce tics in that area.
To address attention problems, doctors may prescribe stimulant medications (for ADHD treatment), which can improve focus but may occasionally worsen tics in some people.
Doctors may also use central adrenergic agonists—originally developed for treating high blood pressure—to calm behavior, improve impulse control, and anger management. A possible side effect is drowsiness.
For symptoms such as sadness, anxiety, or obsessive thoughts, doctors sometimes prescribe selective serotonin reuptake inhibitors (SSRIs).
Research also shows that some individuals may benefit from anticonvulsants for tic reduction.
Types of Therapies
Therapy can help manage tics and related issues. One main approach is Comprehensive Behavioral Intervention for Tics (CBIT). CBIT teaches people to notice urges before a tic and use new actions—called habit reversal training—to prevent the tic.
Relaxation techniques like deep breathing or meditation can lower stress, which might trigger tics. Psychotherapy gives emotional support, especially for problems like anxiety, depression, or obsessions.
In rare, severe cases, doctors may try deep brain stimulation (DBS). This method uses a device to send electrical signals to certain parts of the brain. DBS is still being studied and is not common.
Healthcare providers adjust treatment plans based on what works best and how serious the tics are.
Handling Everyday Life with Tourette Syndrome
Young People Living with Tics
Children with Tourette syndrome may face challenges at school and in social settings. Some ways to help include:
| Tip | Benefit |
|---|---|
| Inform school staff | Reduces misunderstandings |
| Extra test time | Lowers stress |
| Support hobbies | Improves confidence |
| Join groups | Emotional support |
- Speak Up for Your Child: Caregivers can talk with teachers, school bus drivers, and others to explain Tourette syndrome and how it affects their child.
- Special Support at School: Some children do better with tutoring, extra time on tests, or smaller classes. Schools can make these changes to help lower stress and make learning easier.
Caregivers should encourage their child’s hobbies and friendships. Having personal interests and supportive friends helps children feel good about themselves.
Support groups can help both children and parents. Connecting with other families gives useful tips and helps people feel less alone. Starting a local group can support the whole community.
Getting Ready for Your Visit
Steps You Can Take Before the Appointment
Preparing for a specialist visit makes the process smoother. Here are some steps you can take:
- Ask about any special instructions. Some appointments may have requirements, such as not eating before tests.
- Keep a record of symptoms. Write down any tics or behaviors you notice, even if they seem unrelated.
- List important life events. Note any major stress or changes.
- Bring a list of medicines and supplements. Include all prescriptions, over-the-counter items, vitamins, and herbal products.
- Try to capture a video. If you can, record a video showing a typical tic or behavior. This can help the doctor understand the condition.
- Prepare questions for the doctor. Write down things you want to ask. Start with the most important questions in case there’s not enough time.
Sample Questions:
| Question Ideas |
|---|
| What treatments are available? |
| Are medications needed? |
| What therapies might help? |
| Should we see a neurologist or therapist? |
| Will tests like EEG, MRI, or blood work be useful? |
Having these questions ready can help you get the most out of your visit.
What Your Specialist May Ask or Do
The doctor will need details to help make the best plan. Common topics and steps include:
Symptom Timeline: When did tics or other issues start? How often do they appear?
Severity and Patterns: Are symptoms mild or severe? Do they come and go?
Triggers and Relief: What makes symptoms worse or better?
Medical and Family History: Have you had past illnesses? Do any family members have similar issues or past treatments?
Potential Tests: The doctor may suggest an EEG, MRI, or blood tests to gather more information.
Referrals: The doctor may refer you to a neurologist or a therapist, depending on your needs.
Prepare to answer these topics to help your appointment go smoothly. If you don’t understand something, ask for more information or clarification.
