Tourette’s syndrome is a neurological condition that causes involuntary movements and vocal sounds called tics. While many people associate it only with noticeable motor or vocal outbursts, the reality is that Tourette’s can present in a range of more subtle and misunderstood ways. Recognising the broader picture of symptoms can help individuals seek appropriate diagnosis and support earlier.

What are the common misconceptions about Tourette’s?

The most well-known image of Tourette’s involves loud vocal tics or involuntary swearing (coprolalia). However, this symptom only affects a small percentage of people with the condition. In fact, most tics are far less dramatic and may be mistaken for habits, behavioural issues, or anxiety. Many people with Tourette’s do not receive a diagnosis until symptoms become more noticeable or begin to interfere with everyday life.

What are some lesser-known signs to look out for?

Tourette’s syndrome includes both motor and vocal tics, which typically start in childhood and may vary in frequency and severity. In many cases, these tics are mild, go unnoticed, or are dismissed as nervous habits.

Little-known but common signs may include:

Excessive blinking or facial grimacing
Throat clearing, sniffing, or coughing sounds without an obvious cause
Shoulder shrugging or sudden limb movements
Repeating one’s own words or phrases (palilalia)
Touching objects or people repeatedly
Making animal sounds such as grunting or barking
Sudden, brief body twitches
Repetitive movements that come and go
Pre-tic sensations (urges) that cause discomfort until the tic is performed
Temporary ability to suppress tics, followed by a stronger release later

These tics can appear more frequently when a person is tired, stressed, excited, or anxious. Some children may try to hide or control their tics, particularly in social situations.

Is Tourette’s associated with other conditions?

Yes. Tourette’s often occurs alongside other neurodevelopmental or mental health conditions. These include:

ADHD (attention-deficit hyperactivity disorder)
Obsessive-compulsive disorder (OCD)
Anxiety or depression
Learning difficulties

These co-occurring conditions may influence the way tics appear or affect a person’s ability to manage them. In some cases, the associated conditions are more disabling than the tics themselves.

When should you seek a medical opinion?

You should consider speaking to a GP or specialist if you or your child:

Has had one or more motor and vocal tics for over a year
Shows unusual repetitive behaviours or sounds that seem hard to control
Appears distressed, anxious, or socially withdrawn because of the symptoms
Is falling behind at school or having difficulty with concentration and routines

A diagnosis of Tourette’s syndrome is made based on clinical history and observation. There is no single test, but referral to a neurologist or paediatric specialist may be recommended.

Understanding the varied symptoms of Tourette’s can help reduce stigma and delay in diagnosis. With the right support, people with Tourette’s can manage their symptoms effectively and live full, independent lives.