How is Tourette Syndrome diagnosed?

Tourette syndrome does not have a specific test for diagnosis. The diagnosis of the condition is based on the patient’s history of symptoms and signs.

The diagnosis of the condition can sometimes be overlooked due to the signs mimicking those of other conditions. If a patient is always blinking their eyes, they may be experiencing issues with their vision, the same thinking goes for constant sniffing being linked to allergies.

The following criteria are used to diagnose Tourette's:

• Vocal tics and motor tics are both present, however, they do not have to appear at the same time.
• The tics started before the patient turned 18 years old.
• The tics are not the result of other medications, another condition or substances ingested.
• The tics occur a number of times a day, basically every day for more than an entire year.

If a child displays symptoms of Tourette’s, the parent may be advised by their doctor to see a healthcare professional who specialises in diseases of the nervous system – known as a neurologist.

In order to rule out possible other causes of the tics, the neurologist may conduct the following tests:

• Neuroimaging tests:
  • MRI (magnetic resonance imaging) – This test utilises radio waves and powerful magnets to create pictures of structures inside the body.
  • CT (computerised tomography) – This test is a powerful X-ray that creates extremely detailed images of the patient’s organs.
  • EEG (electroencephalogram) – This is a test that detects the electrical activity in the patient’s brain by using electrodes (flat metal discs) that are attached to the patient’s head.
• Blood tests

The doctor will ask the parent (if dealing with a minor) or patient about the symptoms experienced. An accurate diagnosis will require both one vocal tic and one motor tic to have occurred for at least a year.

As mentioned, other conditions will need to be ruled out, the most common of these include:

• ADHD (attention deficit hyperactivity disorder)
• OCD (obsessive-compulsive disorder)
• Learning disabilities
• Sleeping disorders
• Anxiety

Questions the doctor may ask

• What signs were noticed that led to booking an appointment with the doctor?
• Does the patient often move their body in a way that is involuntary? How long have these involuntary movements been happening?
• Does the patient ever say things without the intention to? When did these involuntary vocal tics start?
• Does the patient have issues with focusing or often feel anxious?
• Are there any members of the family who have the same symptoms?

Questions for the doctor

• Will the symptoms go away ad how long will they last?
• Are there any more tests needed?
• What is the treatment plan from here?
• Are there any side effects to be aware of regarding treatment?
• Are there any specialists that need to be seen from here?
• What can be done to help control or lessen the tics?