Symptoms and causes


Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified as:

  • Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.
  • Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.

Tics also can involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.

Common motor tics seen in Tourette syndrome
Simple tics Complex tics
Eye blinking Touching or smelling objects
Head jerking Repeating observed movements
Shoulder shrugging Stepping in a certain pattern
Eye darting Obscene gesturing
Nose twitching Bending or twisting
Mouth movements Hopping
Common vocal tics seen in Tourette syndrome
Simple tics Complex tics
Grunting Repeating one's own words or phrases
Coughing Repeating others' words or phrases
Throat clearing Using vulgar, obscene or swear words

In addition, tics can:

  • Vary in type, frequency and severity
  • Worsen if you're ill, stressed, anxious, tired or excited
  • Occur during sleep
  • Change over time
  • Worsen in the early teenage years and improve during the transition into adulthood

Before the onset of motor or vocal tics, you'll likely experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. Expression of the tic brings relief. With great effort, some people with Tourette syndrome can temporarily stop or hold back a tic.

When to see a doctor

See your child's pediatrician if you notice your child displaying involuntary movements or sounds.

Not all tics indicate Tourette syndrome. Many children develop tics that go away on their own after a few weeks or months. But whenever a child shows unusual behavior, it's important to identify the cause and rule out serious health problems.


The exact cause of Tourette syndrome isn't known. It's a complex disorder likely caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, might play a role.

Risk factors

Risk factors for Tourette syndrome include:

  • Family history. Having a family history of Tourette syndrome or other tic disorders might increase the risk of developing Tourette syndrome.
  • Sex. Males are about three to four times more likely than females to develop Tourette syndrome.


People with Tourette syndrome often lead healthy, active lives. However, Tourette syndrome frequently involves behavioral and social challenges that can harm your self-image.

Conditions often associated with Tourette syndrome include:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Obsessive-compulsive disorder (OCD)
  • Autism spectrum disorder
  • Learning disabilities
  • Sleep disorders
  • Depression
  • Anxiety disorders
  • Pain related to tics, especially headache
  • Anger-management problems