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Tourette Syndrome In Children

What is Tourette syndrome in children?

Tourette syndrome (TS) is a disorder that causes your child to have tics. A tic is when your child makes sudden, fast movements or sounds that he cannot control. The exact cause is not known, but it may be linked to genetic changes that cause problems with chemicals in the brain. These chemicals affect the nerves that help control your child's movements, behavior, emotions, and thoughts.

What increases my child's risk of Tourette syndrome?

Your child is more likely to have TS if a close family member has TS. It is more common in boys and usually begins between the ages of 3 and 8 years old. Ask your child's caregiver for more information about family history and other risk factors for TS.

What kinds of tics will my child have?

Your child may have motor tics, vocal tics, or both:

  • Motor tics: Simple motor tics are short, quick, uncontrolled movements of one body area. Complex motor tics occur when your child has many simple motor tics at one time. Your child may do any of the following:
    • Punch, bite, scratch, or poke at himself
    • Blink his eyes, twitch his nose, or twist his face
    • Bang, shake, or turn his head or shrug his shoulders
    • Copy other's movements, touch other people, or make inappropriate gestures
    • Grind his teeth, tense his abdomen, or vomit
    • Hit, kick, throw things, or do exercises for no known reason
    • Slap his hand, tap his fingers, stamp his feet, or shake his arms or legs
  • Vocal tics: Simple vocal tics are when your child makes uncontrolled noises and sounds. Complex vocal tics are when your child speaks words or phrases without having control over what he is saying. Your child may do any of the following:
    • Bark, sniff, yelp, squeak, whistle, or make a sucking noise
    • Clear his throat, cough, make a hiccup noise, or grunt
    • Copy the sounds or words of another person
    • Curse, shout, scream, or say inappropriate things
    • Make the same sound or noise over and over again
    • Mumble words or sentences

What should I know about tics?

  • Your child's tics may be worse when he is alone, stressed, tired, excited, or worried.
  • Your child may have warning signs before his tics begin, such as feeling cold, warm, itchy, tingly, or heavy. When the tic occurs, these feelings go away.
  • Your child may have fewer tics when he is concentrating, doing activities, or sleeping.
  • At times, your child may be able to stop a tic from occurring. This may cause discomfort or a feeling of pressure in his body, causing him to have many tics afterwards.
  • As your child grows older, his tics may go away on their own.

What other problems might my child have?

Children with TS are more likely to also have attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), or bipolar disorder. Ask your caregiver for more information on these disorders. You child may also experience the following:

  • Your child may be teased or bullied by other children.
  • Your child may be embarrassed about his tics or have low self-esteem.
  • Your child may feel pain when he has certain motor tics.
  • He may have temper tantrums, bully other children or animals, or harm himself.
  • Your child may have trouble sleeping, have bad dreams, or sleepwalk.
  • Your child may have trouble learning in school.

How is Tourette syndrome in children diagnosed?

Your child's caregiver will ask questions about your child's tics and health history. Tell your child's caregiver when the tics started, how often they occur, how bad they are, and if they interfere with daily activities. Tell the caregiver if a family member has TS or another tic disorder. Your child's caregiver may do testing to check your child's brain function. Your child's caregiver may check your child's eyes, strength, memory, and problem solving ability. Tests may also be needed to check for other conditions, such as ADHD, OCD, and learning problems.

What medicines may be used to treat my child's Tourette syndrome?

Medicines may be given if your child's tics are painful, harmful, or make it hard for him to do his normal activities. The medicines used to treat your child will depend on what other conditions he has. The following may be used to treat your child:

  • Alpha 2 adrenergic agonists: This medicine may help decrease your child's tics, anxiety, and trouble sleeping.
  • Antidepressants: Certain antidepressant medicine may help decrease your child's tics. It may help decrease aggressive behavior.
  • Antipsychotics: Antipsychotic medicines may help decrease your child's tics. If your child acts out with aggression, antipsychotics may decrease this behavior. Antipsychotic medicine may cause problems with walking or other movements.
  • Atypical antipsychotics: Atypical antipsychotic medicines are also called second generation antipsychotics. The medicine may help decrease your child's tics and aggressive behavior. Atypical antipsychotics have a decreased risk of causing movement problems.
  • Botulinum toxin: Your child may be given injections (shots) of botulinum toxin to help weaken the muscles involved in his tics. The medicine helps decrease how often and how severe his tics are. The injections may also help control vocal tics.
  • Mood stabilizers: Mood stabilizers help control quick changes in your child's mood that happen for no reason. The medicine may also help decrease the side effects of other medicines, such as movement problems.

What treatments may be needed to help my child with Tourette syndrome?

Stress may make your child's TS worse. Deep breathing, muscle relaxation, meditation, and listening to music can help your child cope with stressful events. The following therapies can also help your child manage his symptoms and decrease stress:

  • Biofeedback training: Biofeedback helps your child to control how his body reacts to stress or pain.
  • Cognitive behavioral therapy: Cognitive behavioral therapy (CBT) helps your child learn to control his behavior, thoughts, and emotions. CBT may help your child better understand TS and help him cope with his symptoms.
  • Habit reversal therapy: During habit reversal therapy (HRT) caregivers help your child learn new behaviors to take the place of his tics.
  • Relaxation therapy: Relaxation therapy helps decrease your child's physical and emotional stress. Relaxation therapy may help your child learn to control his tics.
  • Social skills training: Social skills training helps your child learn to get along with others, including family and other children. This helps decrease his feelings of stress and poor self-esteem so he can better cope with his TS.

What are the risks of Tourette syndrome in children?

  • Medicines used to treat your child may cause him to eat more than usual and gain weight. Medicines may cause your child to have anxiety, trouble sleeping, and trouble with movements, such as walking. Certain medicines may cause your child's head to turn to one side or his jaw to lock. If your child gets botulinum toxin shots, the muscles where the shots are given may feel sore and weak. Some medicines may cause a serious condition called neuroleptic malignant syndrome. This may cause your child to have a high fever, muscle stiffness, and problems thinking clearly. Certain medicines may also cause heart, eye, and stomach problems.
  • If your child's TS is not treated, his tics may get worse and could cause injury. TS may change the way your child thinks of himself and how he gets along with others. Your child's condition may make it hard for him to do his normal activities. Your child may have learning problems, making it hard for him to function well in school. He may become depressed and anxious and have trouble controlling his anger. Your child's risk for abusing alcohol or drugs may increase. Your child may have thoughts of hurting or killing himself or others.

Where can I find more information?

  • Tourette Syndrome Association
    42-40 Bell Boulevard
    Bayside , NY 11361-2820
    Phone: 1- 718 - 224-2999
    Web Address: http://www.tsa-usa.org
  • Worldwide Education and Awareness for Movement Disorders
    WEMOVE
    204 West 84th Street
    New York, , NY 10024
    Web Address: www.wemove.org

When should I contact my child's caregiver?

Contact your caregiver if:

  • Your child is having side effects from his medicine, or his medicine is not helping.
  • Your child is not sleeping well or sleeps more than usual.
  • Your child has trouble in school or becomes depressed or anxious.
  • Your child is having muscle spasms (twitching) or trouble walking.
  • Your child has new tics, or his tics are getting worse or preventing him from doing his normal activities.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your child gets very upset, threatens someone, or is violent. This may include talking loudly, shouting, or becoming very demanding.
  • Your child tells you he feels like hurting himself or others.
  • Your child has hurt himself or someone else.
  • Your child has a high fever, muscle stiffness, and problems thinking.
  • Your child has new changes in his vision.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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