Tourette syndrome (TS) is a neurological disorder characterized by sudden, involuntary movements and/or vocalizations known as tics. Affecting both children and adults, TS is often accompanied by related conditions such as OCD, ADHD, and sleep disorders, making it essential to seek specialized care from an experienced healthcare provider.
At CBT Baltimore, we support individuals and families navigating the challenges of Tourette syndrome with effective behavioral treatments, education, and coordination with pediatricians, neurologists, and other specialists.
What Is Tourette Syndrome?
Tourette syndrome is one of several tic disorders, which also include chronic motor or vocal tic disorder and provisional tic disorder. TS involves both motor tics (e.g., blinking, jerking) and vocal tics (e.g., sniffing, grunting), persisting for over a year.
Tics are often preceded by a premonitory urge—a sensation that builds until the tic is performed. These behaviors are not voluntary and can become more intense under stress or excitement.
Types of Tics
Tics can be classified by type of tic, complexity, and body systems involved:
Motor Tics
- Simple motor tics: eye blinking, facial grimacing, shoulder shrugging
- Complex motor tics: jumping, twirling, repetitive touching, movement of multiple muscle groups
Vocal Tics
- Simple vocal tics: throat clearing, coughing, sniffing
- Complex vocal tics: repeating phrases, echolalia (repeating others), coprolalia (involuntary use of inappropriate language)
While coprolalia is often associated with TS in the media, it affects only a small percentage of people with the condition.
Symptoms of Tourette Syndrome
The symptoms of Tourette syndrome vary in severity and can change over time. They often begin in childhood, peak in early adolescence, and sometimes decrease in early adulthood. Common signs include:
- Frequent eye blinking, facial movements, or grimacing
- Repetitive noises or phrases
- Involuntary movements affecting limbs or posture
- Worsening tics with anxiety or excitement
- Co-occurring issues such as OCD, ADHD, or sleep disorders
Causes and Risk Factors
The exact cause of Tourette syndrome is not fully understood, but research suggests a combination of genetic, neurological, and environmental factors.
Neurological Factors
- Irregularities in neurotransmitters like dopamine and serotonin
- Abnormalities in the nervous system circuits controlling movement and behavior
- Imbalances in brain regions like the basal ganglia
Risk Factors
- Family history of tic disorders
- Male sex (TS is more common in boys)
- Prenatal or birth complications
Institutions like the National Institute of Neurological Disorders and Stroke (NINDS) and NIH continue to explore the complex mechanisms behind TS.
Diagnosis of Tourette Syndrome
Diagnosis is clinical and based on observable symptoms, typically by a pediatrician, neurologist, or psychiatrist. While there is no single test for TS, certain assessments may support diagnosis:
- Medical history and timeline of symptoms
- Blood tests to rule out infections or metabolic causes
- EEG or brain scans to exclude other movement disorders
- Evaluating co-occurring conditions like ADHD, OCD, or vocal tic disorder
The CDC and government health resources recommend early diagnosis to improve outcomes and reduce stigma for children with Tourette syndrome.
Treatment of Tourette Syndrome
Though there is no cure for TS, a range of treatment options is available to help manage tic symptoms and improve quality of life.
1. Comprehensive Behavioral Intervention for Tics (CBIT)
CBIT is the most effective behavioral therapy for TS and involves:
- Habit Reversal Training (HRT)
- Relaxation techniques
- Environmental adjustments
CBIT is supported by the Tourette Association of America and major health care systems as a frontline approach.
2. Medication Management
In moderate to severe tics, pharmacological interventions may be prescribed:
- Antipsychotics: risperidone, haloperidol, aripiprazole, pimozide
- Dopamine depleters: tetrabenazine, topiramate
- Alpha-agonists for tics and ADHD: clonidine, guanfacine
- Botulinum toxin (Botox) injections for localized tics
Medications may cause side effects like drowsiness, weight gain, or even tardive dyskinesia, so clinicians must monitor closely.
3. Advanced Treatments
For rare and treatment-resistant cases, advanced methods may be explored:
- Deep Brain Stimulation (DBS) for disabling tics
- Referral to neurology and psychiatry teams for multidisciplinary care
Experts like Jankovic and Cavanna have published extensively on DBS and other neuromodulation techniques for the treatment of Tourette syndrome.
Life With Tourette Syndrome
Living with TS can be challenging, but it does not define a person’s potential. With access to support groups, school accommodations, therapy, and understanding peers, individuals with TS can thrive socially and academically.
Organizations like the CDC, NIH, and Tourette Association of America provide resources, advocacy, and connections to community care.
How CBT Baltimore Can Help
At CBT Baltimore, we offer:
- Personalized CBIT and CBT treatment plans
- Coordination with your child’s pediatrician and school team
- Referrals to trusted neurology and psychiatry providers
- Education for families and schools on tic disorders
We understand the impact of TS on mental health, social development, and self-esteem, and we’re here to help reduce stigma and empower every client.
Let’s Work Together to Improve Quality of Life
If you or your child is experiencing tic symptoms or has been diagnosed with Tourette syndrome, effective care is available. Schedule a session with CBT Baltimore to explore treatment options and take the first step toward lasting support.