Tourette Syndrome

Gilles de la Tourette (ZHEEL de la too-RETT) syndrome is a neurological disorder that causes a person to make sudden movements or sounds, which are called tics. Many scientists think Tourette syndrome is caused by a chemical imbalance in the brain.

Daniel's Story

When Daniel yelped out loud like a dog, and his classmates erupted with laughter, Ms. Jones sent him to the school office. The teacher knew Daniel was being treated for hyperactivity, but recently he had been blinking his cyes, twitching his nose, and shuffling his feet. Ms. Jones decided she could no longer tolerate his interruptions. She also was concerned about Daniel. Was he just showing off, or could he have a more serious condition? She had read about Tourette syndrome, which causes strange movements and sounds. Was that Daniel's problem?

What Is Tourette Syndrome?

Gilles de la Tourette syndrome is named after the French physician Georges G. A. B. Gilles de la Tourette (1857-1904), who first described the disorder in 1885. It is commonly referred to as Tourette syndrome (TS). The symptoms are tics: abrupt, rapid, and repeated movements or vocal sounds. Researchers have identified more than 80 tics associated with this syndrome, including grunts, barks, babbling, cye movements, head or neck motions, throat clearing, grimaces, shrugging, sniffing, leg and mouth motions, and motions of the torso.

Tics are categorized as either simple or complex. Simple motor tics include twitching of an eye or a jerking movement of the arm. Simple vocal tics include grunts, barks, or other noises. Complex tics involve several coordinated muscle movements, including twirling or doing deep knee bends when walking. Complex vocal tics include stuttering, babbling, uttering profanities, or echoing sounds. The more common tics in Tourette syndrome are:

* Echolalia (eh-koh-LAY-lee-uh): echoing other people's words

* Palilalia (pal-ee-LAY-lee-uh): repeating one's own last words, sounds, or sentences

* Coprolalia (ko-pro-LAY-ee-uh): literally "babbling about feces," but also includes use of explicit and obscene language or sounds

* Echopraxia (ch-koh-PRAK-see-uh): imitating other people's movements

* Copropraxia (ko-pro-PRAK-see-uh): making obscene and socially unacceptable gestures

People with more severe tics may mutilate themselves by biting their lips or banging their heads. Others may exhibit obsessive-compulsive behavior such as excessive hand washing. In addition to tics, a person with Tourette syndrome may show signs of hyperactivity, poor coordination, or attention deficit hyperactivity disorder (ADHD).

People with TS can sometimes control their tics for minutes, but like a suppressed sneeze, the tic returns inevitably. Tics get worse when a person is tired or anxious; they get better when a person is focused and concentrating on something. Severe tics can be more pronounced around family and close friends and less pronounced in the presence of strangers. Tics are less pronounced in the morning, worse at night, and, generally, not evident when a person is sleeping.