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Tourette syndrome: what it is and is not

I was surprised to learn that a friend has Tourette syndrome. I had thought that people with this condition were easy to recognize. What are the symptoms? Can it be treated?

There are a number of myths associated with Tourette syndrome, and one of the most common is that those suffering from the condition have wildly uncontrollable vocal sounds (tics), such as shouting inappropriate or obscene words. However, these behaviors are very rare.

According to Marie-Helene Saint-Hilaire, M.D., assistant professor of neurology at Boston University School of Medicine and a neurologist at Boston Medical Center, "Tourette is an inherited neurological disorder, which usually shows up in people -- more frequently women -- by the time they are 18 years of age." Saint-Hilaire emphasizes that those with Tourette often encounter misinformation among the general public. "There seems to be a stereotype for people with Tourette, and I think that it's been encouraged by inaccurate portrayals on television and in movies."

Named after Georges Gille de la Tourette, the French neurologist who reported the first case of the disorder in 1825, Tourette can take a number of different forms, so many that there is no one "typical" case. The severity and frequency of symptoms usually decreases with age, but can increase under periods of emotional stress. Symptoms range from mild to severe, with most people falling into the mild category. "There are a number of tics that can appear in Tourette patients, including blinking, neck twisting, or continual throat clearing," says Saint-Hilaire. She adds that tics are classified as simple (brief, sudden movements) and complex (distinct, coordinated patterns of successive movements involving several muscle groups).

The exact cause of Tourette syndrome has not been discovered; however, genetic research has identified a gene that seems to cause abnormalities in neurotransmitters (chemicals that carry signals throughout the brain). Because it is an inherited condition, those with Tourette have about a 50 percent chance of passing on the gene to one of their children. Not all people who carry the gene experience the symptoms; they can still pass the gene on to their children, however.

Although there presently is no cure for Tourette syndrome, most people are taught how to control the problem, says Saint-Hilaire, and for some, medication can help them lead relatively normal lives. Physicians may prescribe one of several medications that affect neurotransmitters, including Haldol, Klonopin, and Prozac. Saint-Hilaire also points out that stress-reduction techniques can help. "For Tourette patients," she says, "stress can become a cycle: stress increases tics, but tics also increase stress. By learning to use stress-reduction techniques, Tourette sufferers can help break that cycle."

Children with Tourette syndrome often have additional learning problems, such as attention deficit disorder. Combined with frequent tics, learning disorders may make it difficult for children in standard classroom settings, and they may require special tutoring or learning aids.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on Tourette syndrome or other health matters, call 617-638-6767.

27 April 2001
Boston University
Office of University Relations