Tourette syndromeWhen the body moves or a sound comes out without choice: what it is, and why it is so often misunderstood

13What is Tourette syndrome?

“My son blinks and makes a sound from his throat all day, and his teachers think he’s being funny.” This sentence is heard again and again in pediatric and psychiatric clinics. What looks like stubbornness may be Tourette syndrome, a medically recognized neurological condition, and understanding it completely changes how home and school treat the child.

Tourette syndrome, or Gilles de la Tourette syndrome, named after the French physician who described it, is a disorder of nervous system development that causes tics: sudden, rapid, repeated movements or sounds that the person does not intend. The World Health Organization classifies it among diseases of the nervous system under the code 8A05.00 in the International Classification of Diseases, ICD-11.

According to the UK’s National Health Service (NHS), the diagnosis is considered when tics begin before age 18, last a year or more, and include both movement and sound. Many children go through passing tics that do not necessarily mean they have the syndrome.

14What do tics look like in Tourette syndrome?

It often starts with simple tics of the face and head, such as blinking, grimacing and head jerking, and then vocal tics are added, such as throat clearing and repeated sniffing. Tics change and wax and wane, calming for weeks and then flaring. Many are preceded by an urgent inner sensation, similar to the need to sneeze. For the full details, including simple and complex types and what worsens and eases them, read Symptoms and Signs of Tourette Syndrome.

15How common is Tourette syndrome?

These figures mean Tourette syndrome is not as rare as many think, but mild cases often go undiagnosed because the family regards it as a “habit” that will pass. There are no unified Egyptian figures, but delayed diagnosis is common when tics are interpreted as misbehavior.

16How does Tourette syndrome change with age?

The MSD Manual describes a typical course in most children, with wide variation from child to child:

1. Ages 4–6
   The start

   Often simple motor tics, such as blinking or head jerking.

2. Later
   Sounds appear

   Vocal tics such as throat clearing and sniffing may be added, completing the picture.

3. Ages 10–12
   The peak

   The most severe period of tics for many children.

4. Adolescence
   Easing

   Tics gradually ease in most.

5. Adulthood
   Stabilization

   They disappear or ease considerably, while related conditions may continue.

The StatPearls review confirms that tics usually recede with adulthood, but the accompanying psychiatric and neurological conditions may persist afterward, which is why “the blinking has gone” is not enough to be fully reassured.

17Why does Tourette syndrome happen?

The exact cause is still unknown, but the MSD Manual explains that tic disorders tend to run in families, which is why the doctor asks about affected relatives. The problem is thought to lie in the brain circuits that regulate and inhibit movement. It is not the result of wrong parenting or spoiling, and has nothing to do with the evil eye or possession.

Doctors distinguish between primary tics and secondary tics, which can appear with excessive use of stimulants such as cocaine, or with other neurological conditions, which is why the doctor always asks about medications and substances before confirming the diagnosis.

18What conditions accompany Tourette syndrome?

The MSD Manual notes that teenagers and adults with the condition may also suffer from depression, bipolar disorder or substance use disorder. That is why a good assessment looks for ADHD, obsessive-compulsive disorder and others, not for tics alone.

19Common myths about Tourette syndrome and the truth

20What is the difference between Tourette syndrome, transient tics and obsessive-compulsive disorder?

Not every repeated blink is Tourette. The American DSM-5-TR criteria, as presented in the MSD Manual, divide primary tic disorders into three levels on one spectrum: provisional tic disorder lasting less than a year, persistent (chronic) tic disorder with motor tics only or vocal tics only for more than a year, and then Tourette syndrome when movement and sound are both present for more than a year.

A compulsion in OCD, by contrast, comes in response to a worrying thought to ease anxiety, while a tic comes in response to an urgent physical sensation. The 2022 European guidelines also stress the need to distinguish tics from functional movement disorders in children and adults, a different condition we explain in our guide to conversion disorder.

21How is Tourette syndrome treated?

There is no treatment that cures it completely, and many children do not need treatment for tics at all; the first step is always explanation and reassurance. When tics disrupt life, comprehensive behavioral intervention for tics comes next, then medication if that is not enough, along with treatment of accompanying conditions. The full details of the options and their side effects are in Treatment of Tourette Syndrome.

22When should you see a doctor about tics?

• Tics lasting more than a few months, or combining movement and sound.
• Tics that cause pain or injury, such as violent neck jerking.
• Schooling, work or relationships being affected because of them.
• Obsessive thoughts, severe distractibility, anxiety or persistent sadness.
• Tics appearing after starting a medication or using a stimulant substance.

Assessment usually begins with a pediatrician or neurologist, and the psychiatrist takes part in treating accompanying conditions.

23How can the family support a child with Tourette syndrome?

The most important thing a family can offer is a home where the child is not judged for a movement they do not control. Calmly ignore the tic, listen to what the child says rather than how they say it, and do not ask them to “stop it.” Tell their siblings about the condition so it does not become material for mockery at home. And watch for signs of bullying, sadness and withdrawal, which are more harmful to the child than the tic itself.

24Tourette Syndrome Guide: Everything You Need to Know

We have gathered everything about Tourette syndrome into 2 pages, each answering one question in detail. Choose what you are looking for: