Tourette In Children: Signs, Symptoms, Causes And Treatment

Low birth weight or head injuries may increase the risk of Tourette syndrome.

Medically reviewed by Dr. Anuradha Bansal, MD Dr. Anuradha Bansal Dr. Anuradha BansalMD facebook_iconlinkedin_icon Specialty: Pediatrics and NeonatologyExperience: 13 years
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Tourette In Children: Signs, Symptoms, Causes And Treatment

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Tourette syndrome in children is a neurological condition characterized by recurring tics. The tics in Tourette syndrome (TS) or Tourette disorder (TD) are uncontrolled muscle movements or vocal noises that occur suddenly. The symptoms of the syndrome in children with the condition usually appear between the ages of five and ten years (1).

Most children with TS first display basic tics and later progress to complex tics, which may interfere with daily life. Some children may have weaker tics and require no treatment at all. The severity of the disorder varies from child to child, and you must seek medical help for an individual diagnosis and treatment.

Read on to learn more about the symptoms, causes, diagnosis, treatment, and prevention of Tourette syndrome in children.

Causes Of Tourette Syndrome In Children

The exact cause of Tourette syndrome is not yet known. It can occur due to genetic and environmental factors. Many children with Tourette syndrome have shown an autosomal dominant pattern of inheritance. That means there is a one in two (50%) chance to pass the gene to each child if a parent has Tourette syndrome or a Tourette syndrome gene (2).

About one in 20 children with Tourette syndrome develop the condition without any genetic reasons. The following factors may increase the risk (3).

Boys are about three to four times more likely to develop Tourette syndrome than girls (4).

Signs And Symptoms Of Tourette Syndrome In Children

Uncontrolled muscle movements or tics are characteristic signs of Tourette syndrome. Muscle movements may often occur in the hands, torso, shoulders, neck, or face. Children may have simple tics that involve a few muscles or may have complex tics involving more muscles.

Depending on the type of tics, the following signs and symptoms are seen in children with Tourette disorder (4).

Simple tics may include:

  • Eye blinking
  • Grimacing
  • Head jerking
  • Shrugging
  • Squinting
  • Nose twitches
  • Leg movements, such as leg jerking, scratching, and foot-tapping

Complex tics may include:

  • Touching
  • Bending
  • Walking in a particular pattern
  • Pinching
  • Striking tongue out
  • Lip-smacking
  • Rude or obscene gestures

Vocal tics can be:

  • Barking voices
  • Sniffing
  • Whistling
  • Moaning
  • Hissing
  • Spitting
  • Snorting
  • Coughing
  • Throat clearing
  • Echoing or repeating phrases
  • Using rude words such as obscene words

Sometimes, the type of tics may change over time, such as a child with simple tics may develop complex or vocal tics. Boys are more likely to have chronic tics. Girls with tics are more vulnerable to anxiety disorders, such as obsessive-compulsive disorder (OCD).

It can often be hard to tell if a tic is a normal action or uncontrolled muscle movement. Also, children may have tics for months and then grow out of it, making it difficult to tell if it is abnormal. Therefore, consult a doctor if you observe tics and other uncontrolled movements in your child.

Diagnosis Of Tourette Syndrome In Children

The diagnosis of Tourette disorder is usually made around the age of seven. Doctors will ask about your child’s signs and symptoms and the medical history, including prenatal care, childbirth, developmental delays, and family history, to identify the possible causes of tics (5).

Doctors may also evaluate a child’s behavior and often ask teachers to know about their behavior and interactions. Pediatric psychologists may also assess the child for psychological development. Additional diagnostic tests, such as blood tests and MRI imaging, are often ordered to rule out other causes of vocal tics or muscle tics in children.

Treatment For Tourette Syndrome In Children

There is no cure for Tourette syndrome, but there are several ways to manage the condition effectively. Treatment may vary depending on your child’s symptoms, severity, age, and general health status. Some children may not require any treatment, while a few may need special training, medications, or psychotherapy to cope with the tics.

The following are the various treatment options that could be considered (6).

  • Comprehensive behavioral therapies could help some children deal with tics and reduce it. Treatment specialists can help teach the child various ways to manage tics in different situations. The involvement of parents and teachers could be required to make the therapy effective.
  • Medications could be prescribed to regulate muscle movement or to control neurotransmitters.
  • Antidepressants, stimulants, or other medications could be prescribed if the child has coexisting psychiatric issues,  attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or any other cognitive or emotional problems.

If Tourette syndrome does not cause emotional or learning issues, or does not impact a child’s normal cognitive growth, then no treatment might be required.

You can encourage and support your child to overcome the emotional and physical disabilities they face due to repeated tics. Making the child aware of their condition worsens the symptoms. Tell their teachers and friends about their condition and ask them not to discuss too much around it. You can explain to the child that sometimes connections in their brain behave differently and if they don’t pay attention to symptoms, they will correct automatically. Spending more time in a positive environment, such as supporting peer groups, classroom, or family, may help them gain their independence and self-esteem.

Possible Complications Of Tourette Syndrome In Children

Most children with TS have normal intellectual functioning and learning abilities. Sometimes, the following complications are seen (7).

  • Attention problems
  • Learning difficulties
  • Behavioral issues
  • Mood swings
  • Speaking problems
  • Difficulties in social interaction
  • Depression
  • Anxiety
  • Sleep disorders
  • Repeated movements may also cause pain and headache

Prevention Of Tourette Disorder In Children

There is no definitive method to prevent Tourette disorder in children (8). However, some measures may help reduce the risk.

  • Genetic counseling for affected parents may help many parents to know the risk of having a child with Tourette disorder in a future pregnancy.
  • Proper prenatal care and baby safety measures to avoid head injuries and CO poisoning may reduce the risk for Tourette syndrome.
  • Being observant for any early signs of tics and other disorders can lead to early treatment, which may significantly reduce any long-term issues.

Frequently Asked Questions

1. What age do Tourette’s symptoms begin?

Symptoms of Tourette’s usually appear between the ages of two and 14 years (about six years may be the average) (9).

2. Is Tourette’s considered a disability?

Tourette Syndrome is covered under the Americans with Disabilities Act (ADA) as per the Federal Department of Justice (10).

Tourette syndrome in children causes sudden onset of involuntary muscle movements and vocal sounds. Its diagnosis is usually made at about seven years of age after ruling out other causes of muscle twitches. Learning difficulties, low self-esteem, and anxiety are some complications related to this disorder. Tourette syndrome is often a life-long condition that may be managed with medication and psychotherapies, depending on its severity. The involvement of parents, teachers, and peers plays an important role in supporting children with this condition.

Key Pointers

  • The exact cause of Tourette syndrome is not known. Genetic and environmental factors may play a role.
  • Simple tics such as eye blinking, grimacing, or nose twitches and complex tics such as bending, touching, or lip-smacking are symptoms of Tourette syndrome.
  • There is no cure for Tourrette syndrome, and the existing therapies and medications may help manage the condition.

References

1. What is Tourette Syndrome?; Johns Hopkins Medicine
2. Tourette disorder; Johns Hopkins Medicine
3. Risk Factors and Causes for Tourette Syndrome; The Centers for Disease Control and Prevention
4. Tourette Syndrome; St. Clair Hospital
5. Tourette Syndrome; The National Institute of Neurological Disorders and Stroke
6. Tourette Syndrome Treatments; The Centers for Disease Control and Prevention
7. Tourette’s syndrome; Ireland’s Health Services
8. Tourette Syndrome; Harvard Medical School
9. Tourette’s syndrome; National Health Service, UK
10. Americans with Disabilities Act (ADA); Tourette Association of America
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Dr. Anuradha Bansal
Dr. Anuradha BansalMD
Dr. Anuradha Bansal is a highly accomplished pediatrician and neonatologist with 13 years of professional experience. Presently, she is working as Assistant Professor in the Department of Pediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh.

Read full bio of Dr. Anuradha Bansal
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