Hello, I'm Dr Jeremy Stern, consultant
neurologist at St George's Hospital.
Tourette syndrome is a combination
of involuntary movements
and involuntary noises,
which we call tics,
tending to start in childhood
and tending to get better
as people get older.
It's also associated
with obsessive compulsive disorder, OCD,
and attention deficit
hyperactivity disorder, ADHD.
Tourette syndrome is now known to be
more common than was once thought.
In fact it affects
about one per cent of schoolchildren,
but there's a very wide range
so some will have a very mild
and never have to see a doctor for it
and some will be more severe.
We still don't really know the cause
of Tourette syndrome,
even after a lot of research
for many years,
but we do know in most cases
it runs in families,
so there are generally people
on the mother's or father's side
of somebody with Tourette syndrome
who either have tics
or OCD or ADHD or other features,
and only a minority of patients
will come with Tourette syndrome
with no family history of any kind.
The way Tourette syndrome
affects a person
depends entirely on how severe it is
in that particular individual
and the features for them,
so for a lot of people
tics may be the main problem
and will be noticeable to other
and they may feel self-conscious
Tics can sometimes be bad enough
to get in the way of speaking
or moving around properly
or writing, for instance.
Tics vary from very simple ones,
like, for instance, blinking
or a twitch around the mouth
or the neck,
and vocal tics may just be
a throat-clear or a sniff or a cough.
They can also be far more complex,
where people will shout out words,
and in about ten per cent of cases
they will have involuntary swear words,
which is not as common as people think.
The motor tics can also be more complex,
for instance hopping or squatting
or jumping when they walk.
The tics are not necessarily
triggered by anything.
They come spontaneously
but they will vary according to
the situation the person's in,
so they may be more apparent
when the person is anxious or stressed.
The first line of treatment
for people with Tourette syndrome
is really diagnosis,
so they know the condition
they're trying to deal with themselves.
Some people have tics
bad enough to need medication.
The largest group of drugs we use
are the neuroleptic drugs,
and the effect tends to be
a bit variable from patient to patient.
We also use psychological treatments
and particular forms
of cognitive behavioural therapy,
which can also be very helpful
to help individuals control their tics.
For people who have
a diagnosis of Tourette syndrome
or who think they may have
a very good source of support
is the charity Tourettes Action,
and they also hold a list of specialists
who have a particular interest
in Tourette syndrome
and who are experienced
at diagnosing it and managing it.
With that information you could then
visit your general practitioner
to arrange a specialist referral.
It has to be said it's not all doom
and gloom with Tourette syndrome.
I said it's got a very wide range
and I know people personally
with Tourette syndrome
who have done every kind of job,
pilots, a surgeon, several millionaires,
so I think that any child
with Tourette syndrome
can be reassured that their tics
may well get better
and it shouldn't restrict them in
too much in most cases.