December 29, 2025, 3:03 am | Read time: 5 minutes
Tics that disrupt one’s own body rhythm, a nervous system without a reliable filter, and a persistent stereotype that continues to stigmatize those affected: Tourette syndrome is known but rarely properly understood. How to recognize the difference between tics and how Tourette’s can be treated.
Tourette Syndrome Belongs to Tic Disorders
Tourette syndrome is a complex neurological-psychiatric disorder. Motor and vocal tics that constantly change and vary greatly in intensity are the core symptom. Tourette’s is chronic and always begins in childhood or adolescence. The cause of the disorder is still unclear. The Tourette Society estimates that 0.4 to 0.7 percent of the population in Germany is affected. The syndrome was first described by the French neurologist Georges Gilles de la Tourette in 1885.
Tourette syndrome is part of tic disorders (TS): involuntary body movements or vocalizations that follow no clear rhythm. Examples include rolling eyes, frowning, leg/foot movements, tugging at clothing, clearing the throat, shouting or uttering syllables, sniffing… Such vocal and motor tic disorders are common in childhood and last less than a year. They are temporary. Tics often intensify with stress, fatigue, or excitement and decrease in relaxed situations.
Up to 10 Percent of All Children Affected by Temporary Tic Disorders
According to the Child and Adolescent Psychiatry at the University Hospital Dresden, tic disorders occur temporarily in up to ten percent of all children. Slightly less than half, about four percent, are affected for more than a year. Boys and men are three to four times more likely to be affected by tic disorders than girls and women.1
When Tourette Syndrome Is Diagnosed
In tic disorders that persist for at least a year and begin in childhood or adolescence, it may be—in addition to chronic motor and vocal tic disorders—Tourette syndrome.2 Tourette syndrome is diagnosed when multiple motor and at least one vocal tic occur together for at least a year and begin before the age of 18.1
Shouting Profanities Is Not Tourette’s!
Tourette syndrome is often associated with the involuntary shouting of profanities. This form of vocal tic is called coprolalia, but it occurs in only 10 to 20 percent of those affected.3 The majority have no offensive or socially inappropriate tics.
How persistent this stereotype actually is is shown by a new, yet unpublished, representative survey by Tourette expert Prof. Dr. Kirsten Müller-Vahl. Müller-Vahl is a senior physician in the Department of Clinical Psychiatry and Psychotherapy at the Hannover Medical School and heads the Tourette clinic there. Her survey shows that Tourette syndrome is largely unknown in Germany, and even among those who have heard of it, knowledge remains incomplete. At the same time, stereotypical notions—especially the erroneous equation of TS with coprolalia—are widespread.
What Happens in the Brain with Tourette
Simply put, our brain has an internal filter that ensures only the movements and sounds we truly want are executed. This filter is located in a deep network of brain regions called the basal ganglia. Normally, they sort out unconscious movement impulses—similar to a security check that holds back the unimportant and lets only meaningful signals through.4
In people with Tourette syndrome, this filter does not function reliably. Certain motor or vocal impulses are no longer sufficiently inhibited and pass “through the filter.” The result is the typical tics. The neurotransmitter dopamine, which can be overactive or imbalanced in the affected brain circuits, likely also plays a role, further enhancing signal transmission.
Possible Causes of the Disorder
The exact cause of Tourette syndrome is still not fully understood. It is believed that both genetic and environmental factors, which affect regulatory systems (such as the immune and endocrine systems), may interact to create a neurobiological susceptibility to the development of tics.1
According to the University Hospital Dresden, which conducts research on tics, many research findings suggest that “especially psychosocial stress, pre- and perinatal complications, and infections with group A beta-hemolytic streptococci (GAS)” may play a role in the development or exacerbation of tics.1
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Common Comorbidities
Many people with Tourette syndrome also live with additional psychological or neurological conditions. Particularly common are ADHD, obsessive-compulsive disorders, and various anxiety disorders. Affective disorders, including depressive episodes, also occur more frequently. In affected children, a significant proportion—up to about 20 percent—show additional child and adolescent psychiatric problems, such as emotional developmental disorders, learning difficulties, or behavioral issues.5
Treatment Options
A complete cure for Tourette syndrome is not yet possible. Treatment options can be divided into three main elements.
Behavioral Therapy
Habit reversal training is considered one of the most effective therapies for Tourette’s today. The key is to consciously perceive the typical premonitory urge before a tic and practice an alternative movement that blocks the tic by deliberately tensing another muscle area. This way, the automatic sequence of many tics can be interrupted. According to the Hannover Medical School, 30 to 40 percent of tics can be reduced this way.6
Medication Therapy
A few years ago, medication therapy was the only available treatment for Tourette’s. Today, it is mainly used when tics are severely distressing and behavioral therapy methods are insufficient. The active ingredients usually affect the dopamine system and can significantly reduce tic frequency—up to 60 percent. However, depending on the preparation, they may be associated with possible side effects, so treatment is weighed individually.
Brain Stimulation
Deep brain stimulation (DBS) is considered a relatively new neurosurgical procedure and is only considered for severely affected patients with Tourette syndrome for whom medication and behavioral therapy approaches are no longer sufficient.
A public example of this therapy was the YouTube star Jan Zimmermann, who died in late 2025 from the effects of an epileptic seizure. Zimmermann, who had openly spoken about his life with Tourette syndrome on his channel “Gewitter im Kopf” for many years, had a brain pacemaker implanted in 2022.