Tics are sudden, rapid, recurrent, involuntary (outside a person's control) motor movements or vocalizations. Tourette syndrome is a neurological disorder defined by the presence of motor and vocal tics, present for at least one year, starting in childhood or adolescence, fluctuating in variety and severity over time. Associated behavioral and emotional problems frequently complicate the lives of people with tics and Tourette syndrome. These difficulties range from inability to control impulses to attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), learning disabilities, oppositional defiant disorder etc.
Motor tics begin between the ages of 3 and 8 with vocal tics following the onset of motor tics by several years. In uncomplicated cases, motor and vocal tic severity peaks early in the second decade of life, with many showing a marked reduction of tics by the age of 19 or 20. Tics occur in bouts over the course of a day and wax and wane in severity over the course of weeks to months.
Attention deficit hyperactivity disorder (ADHD), when present, takes a heavy toll with a negative effect on peer acceptance, school performance and self-esteem. Increased irritability and rage attacks are not uncommon in children with Tourette syndrome and ADHD.
Obsessive-compulsive disorder (OCD) is characterized by the presence of unwanted thoughts, impulses, or images that elicit distress (i.e., obsessions). Compulsions are repetitive, purposeful behaviors usually performed in response to an obsession, or according to certain rules, or in a repetitive fashion.
Treatment of Tourette syndrome should be individualized based on the severity and resulting impairment of tics, the presence of comorbid disorders, and the support system available. Reassurance and education of families about tics and Tourette syndrome can allow a conservative approach when tics are mild. When appropriate, behavioral and pharmacological treatments can control symptoms in most cases.
The Rush Parkinson Disease and Movement Disorders Center in Chicago is internationally known for its work in tics and Tourette syndrome. The Rush tic disorders group includes physicians expert in diagnosis and management, including oral medications and botulinum toxin injections, as well as a neuropsychologist trained to provide comprehensive behavioral intervention for tics (CBIT). The basic component of this comprehensive behavioral intervention is habit reversal training (HRT), an approach proven to ameliorate tics. Part of our mission is to be active in research opportunities for patients with tics and Tourette syndrome so that we improve our knowledge of the disorder and discover improved treatments.
Our multidisciplinary team includes eight respected movement disorders neurologists, an adult psychiatrist, a neuropsychologist, specially trained nurses, a videographer and numerous support staff.