• Clinical science

Tourette syndrome


Tourette syndrome is a severe neurological movement disorder characterized by tics, which are involuntary, repeated, intermittent movements or vocalizations. It is a genetic disorder that commonly presents in boys and is often associated with attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). Diagnosis is based upon multiple motor tics and at least one vocal tic, lasting for longer than a year, and the exclusion of other suspected medical conditions. Treatment is symptomatic and includes behavioral therapy and dopamine antagonists. Approximately 50% of cases resolve by adulthood.


  • Sex: >
  • Age of onset: usually 2–15 years of age


Epidemiological data refers to the US, unless otherwise specified.



Clinical features

  • Tics
    • Sudden and rapid involuntary, intermittent, nonrhythmic movements or vocalizations without any recognizable purpose
    • Temporarily suppressible
    • An urge or sensation preceding the tic is relieved by its onset.
Simple Complex
Vocal tics
  • Throat clearing
  • Grunting
  • Lip smacking
  • Barking
  • Sniffing
  • Coprolalia: uttering obscene or socially inappropriate words or phrases
  • Echolalia: repeating vocalizations of others
Motor tics
  • Facial grimacing
  • Blinking
  • Shoulder shrugging
  • Head jerking
  • Jumping
  • Twisting the body
  • Echopraxia: repeating movements of others



  • Clinical diagnosis based on all of the following:

    • Multiple motor tics and at least 1 vocal tic with a variable anatomical location, frequency, number, frequency, complexity, type, or severity over time
    • Onset before 18 years of age
    • Lasting > 1 year
    • Not explained by other medical conditions or substance use (e.g., cocaine)


Differential diagnoses


The differential diagnoses listed here are not exhaustive.


Treatment of associated conditions (i.e., ADHD or OCD) can improve symptoms!



  • Symptoms peak during adolescence and improve during adulthood.
  • May resolve spontaneously by 18 years of age (50% of cases)


last updated 06/17/2020
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