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How is Tourette Syndrome diagnosed?

A diagnosis is made by observing symptoms and by evaluating the history of their onset. No blood analysis, x-ray or other type of medical test exists to identify TS. However, a doctor may wish to order an EEG, CAT scan or certain blood tests to rule out other ailments that could rarely be confused with TS.

Is TS inherited?

Genetic studies indicate tic disorders, including TS, are inherited as a dominant gene that may produce varying symptoms in different family members. A person with TS has about a 50% chance of passing the gene to one of his/her children. However, the gene may express as TS, as a milder tic disorder, or as obsessive compulsive symptoms with no tics at all. It is known that a higher than usual incidence of milder tic disorders and obsessive compulsive behaviors are more common in the families of TS patients.

The sex of the child also influences the expression of the gene. The chance that the child of a person with TS will have the disorder is at least three times higher for a son than for a daughter. Yet only a minority of the children who inherit the gene will have symptoms severe enough to ever require medical attention. In some cases, TS may not be inherited; these cases are identified as "sporadic" TS because a genetic link cannot be found.

Is there a cure?

Not yet.

Is there ever a remission?

Remission can occur at any time. Present data suggests that the tic symptoms tend to stabilize and become less severe in adult life. Those diagnosed with TS can anticipate a normal life span.

How is Tourette Syndrome treated?

The majority of people with TS are not significantly disabled by their tics or behavioral symptoms and therefore do not require medication. However, there are medications to help control symptoms when they interfere with functioning. The drugs include haloperidol (Haldol®), pimozide (Orap®), clonidine (Catapres®), clonazepam (Rivotril®) and nitrazepam (Mogadon®). Stimulants such as methylphenidate (Ritalin®) and dextroamphetamine (Dexedrine®), that are prescribed for hyperactivity may temporarily increase tics and should be used cautiously. Obsessive compulsive symptoms may be controlled with fluoxetine (Prozax®), clomipramine (Anafranil®) and other similar medications.

The dosage necessary to achieve maximum control of symptoms varies for each patient and must be gauged carefully by a doctor. The medicine is administered in small doses with gradual increases to the point where there is a maximum alleviation of symptoms with minimal side effects. Some of the undesirable reactions to medications are fatigue, motor restlessness, weight gain and social withdrawal, most of which can be reduced with specific medications. Side effects such as depression and cognitive impairment can sometimes be alleviated with dosage reduction or a change of medication.

Other types of therapy may also be helpful. Sometimes psychotherapy can assist a person with TS and help his/her family cope with the psycho-social problems associated with TS. Some behavioral therapies can teach the substitution of one tic with another that is more acceptable. The use of relaxation techniques and/or biofeedback may help during prolonged periods of high stress.

Do students with Tourette Syndrome have special educational needs?

When difficulties in school cannot be resolved, an educational evaluation may be indicated. Any child thus recognized as needing a specially designed program is entitled to the development and application of that program by his or her Board of Education.

continue: Importance of Early Diagnosis and Treatment, Career Planning, and Support Organizations

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Reviewed: 03/2006