Dr. Demerjian Center For TMJ And Sleep Therapy

Burbank: (818) 238-9865 | Glendora: (626) 852-1865

2701 W Alameda Ave. #606, Burbank CA 91505

175 N. Pennsylvania Ave. #4, Glendora CA 91741

Tourette Syndrome

Tourette Syndrome (TS) is a neurological disorder characterized by involuntary movements (tics) and vocalizations. Tics occur frequently and rapidly and can present itself on the face, specific body parts, or the entire body. These uncontrollable motor movements may start as an eye blink or a nose twitch, but can progress to more complicated movements such as kicking or stamping (nTSA, 2012). Verbal tics, such as groaning or throat clearing, usually accompany these involuntary movements. Echolalia, or the spontaneous utterance of sounds, is a well-documented symptom of TS (Sims & Demerjian, 2012), although corpolalia, or involuntary swearing, which is popularly associated with the disorder, is a rare occurrence (nTSA, 2012). Symptoms of TS include either simple or complex tics and often get worse with intense emotions, excitement, or anxiety (NINDS, 2012).

TS can first present itself between 3 to 9 years of age and affect males about 3 to 4 times more often than women (NINDS, 2012). Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), and other learning disabilities are also found to be associated with Tourette Syndrome (nTSA, 2012). Researchers suggest that there is a genetic component of TS, but no definitive cause of the disorder has been found. Treatments for Tourette Syndrome include medication (e.g., neuroleptics) that helps control symptoms that interfere with daily life; however, as with all medication, side effects do occur (NINDS, 2012). Behavioral treatments such as Cognitive Behavioral Intervention for Tics or supportive therapy have also shown some promise to help people with TS cope with the disorder (NINDS, 2012).

Other treatments for Tourette Syndrome are currently being studied and developed. Some research is focusing on the movement dysfunction involved in TS, using their neurological basis to uncover the relationship between the disorder and problems associated with specific cranial nerves and the motor neurons that they affect (Sims & Stack, 2009). For example, shoulder shrugging is a documented clinical sign of TS. A vast neuronal network affects the voluntary and involuntary movement of the shoulder muscles, and when it is stimulated by a specific cranial nerve (trigeminal), the shoulder shrugging occurs (Sims & Demerjian, 2012). Accordingly, the trigeminal nerve has been implicated in motor dysfunctions and is thought to affect the temporomandibular joint (Demerjian, Sims, & Stack, 2011). This relationship, then, becomes the premise for an alternative treatment for motor disorders, such as TS. By repositioning the teeth and lower jaw to augment the compression of the auriculotemporal nerve endings in the TMJ, stimulation of the nerves that affect shoulder movements cease, and the shoulder shrugging tic diminishes (Sims & Demerjian, 2012). Similar relationships between specific cranial nerves and the nerves that are connected to the TMJ produce similar results, namely a decrease in the urge to produce tics (Sims & Stack, 2009).


Demerjian, G., Sims, A., & Stack, B. (2011). Proteomic signature of Temporomandibular Joint Disorders (TMD): Toward diagnostically predictive biomarkers. Bioinformation, (5)7, 282-284.

National Tourette Syndrome Association (nTSA), 2012. Facts about Tourette syndrome. [PDF]. National Tourette Syndrome Association. Retrieved on September 14, 2012 at http://tsa-usa.org/imaganw/Fact_Sheet.pdf

National Tourette Syndrome Assocation (nTSA), 2012. What is Tourette syndrome. National Tourette Syndrome Association. Retrieved on September 14, 2012 at http://tsa-usa.org/aMedical/whatists.html

NINDS, 2012. Tourette syndrome fact sheet. National Institude of Neurological Disorders and Stroke. Retrieved on September 14, 2012 at http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm#201653231

Sims, A. & Stack, B. (2009). Tourette’s syndrome: A pilot study for the discontinuance of a movement disorder. The Journal of Craniomandibular Practice, 27 (1), 11-18. Retrieved on September 14, 2012 at http://www.tmjstack.com/casereport.pdf