As a parent, noticing your child making unusual movements or sounds can be confusing and even concerning. Tourette Syndrome, a neurological condition characterized by motor and vocal tics, is often misunderstood. Understanding how Tourette Syndrome is diagnosed can offer clarity, open doors to effective treatment, and provide peace of mind as you support your child in getting the care they need.
What Is Tourette Syndrome?
Tourette Syndrome is a neurological disorder characterized by involuntary and repetitive movements and sounds known as tics.
Tics are categorized as:
- Motor tics (involving movements): Movements can include blinking, shrugging or jerking
- Vocal tics (involving sounds): Sounds can include throat clearing, sniffing or words
At What Age is Tourette Syndrome Diagnosed?
Tourette Syndrome is most commonly diagnosed in childhood, often between ages 5 and 10. Symptoms typically reach their peak in early adolescence and sometimes improve in adulthood.
Tourette Syndrome is more common in boys than girls and frequently coexists with other conditions, such as ADHD (attention-deficit/hyperactivity disorder) or OCD (obsessive-compulsive disorder).
How Does Tourette Syndrome Start?
Tourette Syndrome typically begins with simple motor tics, especially those affecting the head and neck, such as eye blinking or facial movements. Over time, these symptoms can sometimes progress to more complex motor or vocal tics, such as those involving multiple body parts.
Someone who has Tourette Syndrome may be able to temporarily suppress their tics, but they cannot prevent their tics. Stress, excitement or fatigue can exacerbate symptoms, although tics can also occur in calm moments.
How is Tourette Syndrome Diagnosed?
Diagnosing Tourette Syndrome involves careful evaluation by a healthcare professional, usually a pediatrician, neurologist, psychiatrist or other mental healthcare provider.
There is no blood, lab or imaging test needed for diagnosis of for Tourette Syndrome. A diagnosis is typically based on clinical observation and criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a guide used by healthcare professionals to diagnose and classify mental health conditions.
Key diagnostic criteria for Tourette Syndrome include:
- Presence of both motor and vocal tics: An individual with Tourette Syndrome must have at least one vocal tic and two motor tics; these tics do not need to occur at the same time. Tics can occur multiple times a day, nearly every day or intermittently.
- Duration of one year: Symptoms must have been present for at least one year. Symptoms may come and go, and vary in terms of frequency depending on the stage of life and environment.
- Age of onset: Symptoms must begin before age 18.
- No other underlying cause: Symptoms cannot be attributed to another condition (such as OCD), or medication or substance use.
How Do You Detect Tics?
Doctors often rely on observation of tics during a meeting with a patient. A provider may need to observe tics over time, such as over the course of several appointments, since tics can sometimes be subtle, vary in different environments and situations, or be attributed to other conditions such as seasonal allergies (for sniffing tics) or vision problems (for eye blinking tics).
Parents and teachers might be asked to document the frequency and nature of tics to help a doctor make a diagnosis.
Can a Brain Scan Show Tourette Syndrome?
Brain scans like MRIs or CT scans do not diagnose TS, as the condition does not show structural abnormalities in the brain. Blood tests are also not useful for making a TS diagnosis.
However, in a small percentage of cases, imaging can be used to rule out other neurological conditions that could mimic symptoms of Tourette Syndrome.
What Else Can Be Mistaken for Tourette Syndrome?
Other conditions that can sometimes be confused with TS can include:
- Seizure disorders: Brief seizures may sometimes resemble tics.
- Psychiatric disorders: This can include OCD, where repetitive behaviors can appear tic-like in some cases
- Other issues that affect the eyes and vision (which can cause blinking) or seasonal allergies (which can cause frequent sniffing or throat clearing)
Understanding a Tourette Syndrome Diagnosis
Receiving a Tourette Syndrome diagnosis can sometimes bring relief to families by providing an explanation for a child’s behavior. When parents learn that tics are involuntary and not within their child’s control, it helps to build empathy and support.
Next Steps
After a diagnosis of Tourette Syndrome, the next step is to determine the best approach to treatment. While there is no cure for TS, a combination of strategies can often help manage symptoms and improve quality of life.
Treatment options for Tourette Syndrome can include:
- Behavioral therapy: Comprehensive Behavioral Intervention for Tics (CBIT) is a specialized therapy that teaches people techniques to manage tics
- Medication: Certain drugs, such as dopamine blockers or alpha-adrenergic agonists, are used in some cases to help reduce tic severity
- Lifestyle adjustments: Stress management and healthy routines, including getting enough sleep, can often help to reduce tics
- Support networks: Connecting with support groups and educational resources can be invaluable for families
The Stony Brook TAA Center of Excellence for Tourette Syndrome and Tic Disorders is the only Tourette Association of America-designated center on Long Island, and one of just 23 in the U.S. We provide multidisciplinary care for individuals of all ages with Tourette Syndrome and tic disorders, serve as a resource for healthcare professionals and advocate for our community. Learn more about the center and schedule a consultation here.
