Tourette's Syndrome
(Gilles de la Tourette Syndrome · GTS · Tourette's)
In this condition factsheet:
Diagnosing Tourette's Syndrome
Tourette syndrome (TS) is diagnosed based on symptoms – a person must have both multiple motor tics and one or more vocal tics for at least one year, before the age of 18, to be diagnosed with TS. The motor and vocal tics do not have to occur continuously or at the same time, but they should not be caused by medication use or other medical conditions.
Doctors may order magnetic resonance imaging scans (MRIs), computerized axial tomography (CAT) scans, or blood tests, but their purpose is to rule out other possible causes - not to find TS.
Most physicians can easily diagnose people with typical TS symptoms. However, people with atypical symptoms or symptoms that start later in life may be more difficult to diagnose. It may take a while before a person gets a diagnosis of TS, mainly because many mild tics may be attributed to other causes (e.g., constant sniffing due to allergies).
Treating and Preventing Tourette's Syndrome
There is no cure for TS, and most people with TS do not need medications to control tics or other behaviour symptoms. However, people with symptoms that interfere with school, social life, or work can benefit from behavioural therapies or medications to help control symptoms.
Habit reversal training (HRT) may be effective for controlling symptoms of TS and improving tics. HRT involves learning to recognize the early warning signs of a tic and training yourself to do a different movement that makes it difficult to do the tic.
Neuroleptic medications such as haloperidol*, aripiprazole, or pimozide can be used to help suppress tics. The goal of using these medications is not to eliminate tics but to control them enough, while avoiding bothersome side effects. If side effects do occur, they can usually be managed by lowering the dose or by sometimes adding another medication to control the side effect. Clonidine, a high blood pressure medication, may also be used to help control tics. Because the symptoms of TS can fluctuate over time (days to years), a long observation period will be necessary for determining how effective a treatment is.
Other treatment options include:botulinum toxin injection and surgical implantation of deep brain stimulation (DBS) electrodes connected to a current generator (similar to a pacemaker for the heart) for reduction of motor and vocal tics in affected muscles. DBS should only be offered to well-vetted patients that have not had success with other therapies.
Many children with TS also have ADHD. There is some concern that the medications given for this condition (e.g., methylphenidate, dextroamphetamine) can increase tics. You should talk to your doctor if you have concerns about this. OCD can be managed with medications and behavioural therapy.
Most children with TS attend a regular school, but they may require special settings to help with their learning (i.e., untimed exams, writing exams in a private area). It is important that teachers and other students understand TS and that they are compassionate and tolerant of a student with TS. If not, some TS symptoms can lead to severe problems at school, both with teachers and with other children.
Psychotherapy may also help people with TS cope with the psychological and social effects of the condition.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
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