Tourette Syndrome

Gilles de la Tourette (ZHEEL de la too-RETT) syndrome (called Tourette) is a neurological disorder that causes a person to make sudden movements or sounds, which are called tics. Many scientists think Tourette syndrome is caused by a chemical imbalance in the brain.

Daniel's Story

When Daniel yelped out loud like a dog, and his classmates erupted with laughter, Ms. Jones sent him to the school office. The teacher knew Daniel was being treated for hyperactivity, but recently he had been blinking his eyes, twitching his nose, and shufHing his feet. Ms. Jones decided she could no longer tolerate his interruptions. She also was concerned about Daniel. Was he just showing off, or could he have a more serious condition? She had read about Tourette syndrome, which causes strange movements and sounds. Was that Daniel's problem?

What Is Tourette Syndrome?

Gilles de la Tourette syndrome is named after the French physician Georges G. A. B. Gilles de la Tourette (1857–1904), who first described the disorder in 1885. It is commonly referred to as Tourette syndrome (TS). The symptoms are tics: abrupt, rapid, and repeated movements or vocal sounds. Researchers have identified more than 80 tics associated with this syndrome, including grunts, barks, babbling, eye movements, head or neck motions, throat clearing, grimaces, shrugging, sniffing, leg and mouth motions, and motions of the torso.

Professional soccer goalie Tim Howard has Tourette syndrome.

Professional soccer goalie Tim Howard has Tourette syndrome.
dpa picture alliance archive/Alamy.

Tics are categorized as either simple or complex. Simple motor tics include twitching of an eye or a jerking movement of the arm. Simple vocal tics include grunts, barks, or other noises. Complex tics involve several coordinated muscle movements, including twirling or doing deep knee bends when walking. Complex vocal tics include stuttering, babbling, uttering profanities, or echoing sounds. The more common tics in TS are:

People with more severe tics may mutilate themselves by biting their lips or banging their heads. Others may exhibit obsessive-compulsive behavior such as excessive hand washing. In addition to tics, a person with TS may show signs of hyperactivity, poor coordination, or attention deficit hyperactivity disorder (ADHD).

People with TS can sometimes control their tics for minutes, but like a suppressed sneeze, the tic inevitably returns. Tics get worse when a person is tired or anxious; they get better when a person is focused and concentrating on something. Severe tics can be more pronounced around family and close friends and less pronounced in the presence of strangers. Tics are less pronounced in the morning, worse at night, and, generally, not evident when a person is sleeping.


Samuel Johnson (1709–1784) is a towering figure in English literature. He wrote essays, poetry, and in 1755 the monumental Dictionary of the English Language. Johnson's friends recognized that he was a brilliant writer. They also thought he was quite eccentric.

Johnson was always in motion, rocking or swerving. He twitched and grunted and blew out his breath like a whale. His friends noticed he had obsessive-compulsive behaviors. For example, when he walked outside, he maneuvered so that he never walked on cracks in the paving stones, and he touched every post he passed. If he missed a post, he would go back to touch it. He also would scrape his fingernails and joints with a knife until they were raw.

When Samuel Johnson died in 1784, a physician examined his brain, looking for evidence of disease. He found none. Based on the observations and letters of his friends, most modern scholars believe Johnson had Tourette syndrome.

The disorder usually begins in childhood. Symptoms appear around age seven, and 90 percent of cases develop before age 10. Boys are four times more likely to develop TS than girls. About 1 person in 2,000 has TS.

At least 25 percent of all children display a simple tic. However, these tics go away within a year and are not a sign of TS. A person with TS may have tics for a lifetime, although the frequency and type of tic may change. About 35 percent of people with TS experience an easing of symptoms in adolescence; most others find that, even if they do not disappear, tics become less frequent and less severe in adulthood. The reverse can also be true: Some people with mild symptoms develop severe tics in their 20s or early 30s.

People with TS may suffer social embarrassment or emotional stress due to their tics. The disorder does not affect their intelligence or ability to lead a full life.

What Causes Tourette Syndrome?

In the Middle Ages, people who displayed movement and vocal tics were thought to be possessed by demons. Gilles de la Tourette, the French physician who studied the disorder in the 1800s, thought TS had a physiological basis, which means that its cause was physical, not mental. Modern scientists think Gilles de la Tourette was right.


Jim Eisenreich (b. 1959) was different from other children. His body was constantly in motion, but not in the same way as other active children. His head twitched from side to side, and his shoulders jerked and shrugged. He often grunted, suddenly, for no apparent reason. His classmates laughed at his odd behavior. Doctors said Eisenreich was hyperactive and nervous and would outgrow the behavior. He did not.

Because he was embarrassed by his behavior, Eisenreich kept to himself and concentrated on baseball. He was a terrific baseball player, and in 1982, he won a spot on the Minnesota Twins.

Baseball in the big leagues was competitive and stressful. Much to his embarrassment, Eisenreich began to experience tics on the field in front of thousands of fans. His neck and shoulders twitched. His face twitched. One day, deeply embarrassed, Eisenreich walked off the field.

Eisenreich retired from baseball for four years. During those years, he sought medical help and discovered the reason for the tics: He had Tourette syndrome. Medication helped ease the tics and counseling helped Eisenreich accept himself.

Eisenreich returned to baseball and became a star hitter and outfielder for the Philadelphia Phillies. In the second game of the 1993 World Series, he smacked a three-run home run that helped Philadelphia beat the Toronto Blue Jays. Eisenreich had returned to baseball with a new outlook on life and on a condition known as TS.

Scientists believe TS is caused by an abnormality in the brain's neurotransmitters, which are chemicals that carry signals from one nerve cell to another. The affected neurotransmitter is dopamine, a chemical that controls movement. Research indicates that some forms of TS are inherited, which means they are passed down from parent to child.

How Do Doctors Treat Tourette Syndrome?

An accurate and prompt diagnosis is important to a person with TS, especially if the symptoms surface during childhood. People with TS are often misunderstood or ridiculed, and children may be punished for behavior that is out of their control.

Most people with TS do not need medication. Medication is reserved for people with severe or disruptive cases of TS. For those with severe tics, medication can reduce the frequency and severity of their symptoms so they can function at school, at work, and in social settings.

See also Anxiety and Anxiety Disorders: Overview • Attention Deficit Hyperactivity Disorder (ADHD) • Obsessive-Compulsive Disorder • Tic Disorders: Overview


Books and Articles

Kutscher, Martin L. Kids in the Syndrome Mix of ADHD, LD, Autism Spectrum, Tourette's, Anxiety, and More! 2nd ed. Philadelphia: Jessica Kingsley, 2014.

Leicester, Mal. Can I Tell You About Tourette Syndrome? Philadelphia: Jessica Kingsley, 2014.

Rack, Jessie. “For Kids with Tourette's, At-Home Training Could Help.” National Public Radio, July 22, 2015. (accessed November 17, 2015).

Robertson, William C. “Tourette Syndrome and Other Tic Disorders.” Medscape, April 30, 2014. (accessed November 17, 2015).


Centers for Disease Control and Prevention. “Tourette Syndrome (TS).” (accessed November 17, 2015).

MedlinePlus. “Tourette Syndrome.” U.S. National Library of Medicine. (accessed November 17, 2015).

National Institute of Neurological Disorders and Stroke. “Tourette Syndrome Fact Sheet.” (accessed November 17, 2015).

NHS Choices. “Tourette's Syndrome.” National Health Service. (accessed November 17, 2015).


American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Ave. NW, Washington, DC 20016-3007. Telephone: 202966-7300. Website: (accessed November 17, 2015).

American Academy of Family Physicians. PO Box 11210, Shawnee Mission, KS 66207-1210. Toll-free: 800-274-2237. Website: (accessed November 17, 2015).

American Academy of Neurology. 201 Chicago Ave., Minneapolis, MN 55415. Toll-free: 800-879-1960. Website: (accessed November 17, 2015).

American Academy of Pediatrics. 141 Northwest Point Blvd., Elk Grove Village, IL 60007-1098. Toll-free: 800-433-9016. Website: (accessed November 17, 2015).

American College of Pediatricians. PO Box 357190, Gainesville, FL 32635-7190. Telephone: 352-376-1877. Website: (accessed November 17, 2015).

Tourette Syndrome Association. 42-40 Bell Blvd, Bayside, NY 11361. Toll-free: 718-224-2999. Website: (accessed November 17, 2015).

  This information is not a tool for self-diagnosis or a substitute for professional care.