Complaints & connections · borters.ch
Syndroma Gilles de la Tourette
Tics are neither bad behaviour nor switchable off — attention amplifies them, calm takes the pressure out.
Also known as: Tourette’s · tics · tic disorder · provisional tic disorder · motor tics · vocal tics · twitches
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Tics are sudden, rapid movements or sounds that keep coming back: blinking, nose wrinkling, shoulder shrugging, throat clearing, sniffing, coughing. Tourette syndrome is diagnosed when both motor and vocal tics have been present for more than a year. The key point: tics cannot be suppressed by willpower for long. Many children hold them back for minutes, in a music lesson or at the doctor’s — but it costs enormous energy and then discharges all the more strongly afterwards, usually at home. Most feel a warning sensation beforehand, the premonitory urge: a tingling, pressure or tension that only eases once the tic is carried out — much like the urge to sneeze. Pointing it out (“just stop that”) reliably makes tics worse. Tics run in waves, change form and increase with excitement, tiredness, stress and even happy anticipation. The good news: most tics that begin in childhood become markedly milder or disappear by young adulthood. Blurting out swear words, coprolalia, affects only a minority and is not the leading symptom — this image from films and comedy is by far the most widespread. ADHD and obsessive-compulsive symptoms often come with tics and frequently burden daily life more than the tics themselves. Girls are recognised later on average. In Switzerland assessment runs via the paediatrician and, if needed, paediatric neurology or child psychiatry.
For adults with very severe tics in whom behavioural therapy and medication are exhausted, deep brain stimulation exists. It is not a usual route and is offered in specialised centres — nothing is destroyed, the stimulation can be adjusted and switched off again.
Every “stop that” focuses attention on the tic and amplifies it. Calmly carrying on is the most effective immediate step.
A short, factual explanation removes laughter and suspicion of intent — more relieving than any hiding.
An agreed place where tics may run without an audience saves the energy otherwise spent suppressing them.
Habit reversal training and related methods work with the premonitory urge and are first choice for burdensome tics.
Tiredness, packed schedules and even big excitement amplify tics. A calm rhythm often helps more than any exercise.
They often co-occur, are treatable and frequently determine how burdensome daily life really is.
Extra time, a separate room for exams or oral alternatives offset the time that tics cost.
Knowing that tics come and go and usually fade over the years removes the fear of staying like this forever.
No drug removes tics. What exists damps them: tiapride and aripiprazole work within weeks and lower tics by about a third to a half; weight gain and tiredness are the most common companions. Treatment is given only when the tics are a burden — not because they are visible. What works at least as well in comparisons and has no side effect is behavioural training that practises a competing response to the premonitory feeling: eight to ten sessions.
Tics usually begin between five and seven and peak around ten to twelve. In about half they become distinctly fewer or disappear in adulthood. The diagnosis needs several movement tics and at least one sound tic over more than a year. About one in a hundred children is affected; the swearing many associate with it affects fewer than one in ten. Tics can be suppressed for minutes — the pressure builds during that and discharges afterwards.
Blinking, grimacing, head jerks or shoulder shrugs return in bursts — not acted, not meant as provocation.
Constant throat clearing, sniffing or coughing without a cold often leads to the ENT doctor before the right explanation.
Older children describe a tingle or pressure that only goes once the tic has happened — like needing to sneeze.
Strong for weeks, then nearly gone, then a completely new tic. That fluctuation is typical, not a sign of intent.
Barely visible at school, much stronger at home — the suppression cost energy that now releases.
ADHD and obsessive thoughts or checking rituals often join in and weigh more heavily than the tics.
A low iron store is common in children and is linked with stronger tics and with restless legs. Not a value that makes the diagnosis — but one that can simply be put right.
A lack causes exhaustion, problems concentrating, low mood and forgetfulness — and it is one of the few causes that can be found and put right with a single blood draw.
Low values are common with low mood. Whether correcting it lifts the mood is not settled; that it makes sense in winter at our latitudes is.
An empty store causes tiredness, lack of drive and problems concentrating long before any anaemia becomes visible. In women of childbearing age the most common single reason.
A building block of the cell coverings in the brain. The studies on mood are inconsistent; as part of a good diet it belongs there anyway.
Needed for making the messengers in the brain. It runs short with alcohol and under certain medicines — and it is always judged together with B12.
Frequently tried, barely studied. A small Spanish trial with magnesium and vitamin B6 found a decrease in tics; it is too small to build on. Tolerable in usual amounts — with diarrhoea the form is to blame, not the dose.
The most reliable observation in this field is not an addition but a leaving-out: lack of sleep and plenty of caffeine markedly increase tics in most people, and both are checkable on oneself. Two weeks without an energy drink say more than any capsule.
Low ferritin is more common in tic disorders as in restless legs than on average. Whether that is cause or company is open — the measurement costs little and answers a question that otherwise stays open.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
The circuits between the cortex and deeper areas work here with a different sensitivity to this messenger. The medicines used with strong tics rest on that.
Tension, excitement and tiredness strengthen tics; relaxation and being absorbed in an activity lessen them. That is why admonitions achieve the opposite.
Lack of sleep reliably strengthens tics. A steady rhythm is therefore among the measures one holds in one’s own hands.
Many report more tics after energy drinks and coffee. Controlled studies are lacking; a diary over 2–4 weeks shows whether it applies to one’s own child.
Habit reversal training is the best-studied non-drug treatment. Relaxation alone hardly reduces the tics but eases the tension that amplifies them.