About one in ten children have tics of some kind, and one in ten of them have Tourette syndrome. Tourette syndrome is usually diagnosed by age nine, and is at its worst in the teenage years. One patient in whom Dr. Georges Gilles de la Tourette first described the condition in 1885 was 86 years old.
The common view of the condition is of uncontrollable cursing, a phenomenon known as coprolalia. However, this is actually a very rare symptom of the condition. Most patients’ tics are nothing more alarming than blinking and throat clearing, notable only by frequency—and even that can vary. The most common verbal tics associated with TS are repeating words.
Tourette patients describe their tics as a releasing of tension and say in the moment it often feels like a voluntary act. Indeed, the tics can generally be suppressed briefly, and patients can typically feel tics coming on even when they can’t stop them.
The condition itself usually is allowed to be untreated unless the tics are severe or cause significant stress. However, Tourette patients often demonstrate other disorders as well, such as attention deficit or obsessive-compulsive disorder, for which treatment is generally indicated. When treatment is used, it’s usually behavioral therapy. Available medical treatments are narcoleptic drugs such as Haldol—which often have severe and debilitating side effects—or some types of blood pressure medications.
Tourette syndrome results from a combination of genetic and environmental factors, though the exact cause remains a mystery. At one time, it was believed that streptococcal infection led to Tourette, but investigations of the supposed connection have found no evidence supporting it and no mechanism by which it might occur. However, tics do seem to be connected with autoimmune conditions.