TOURETTE SYNDROME
 
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TOURETTE SYNDROME

 

DEFINITION:

A movement disorder characterized by single or multiple motor and vocal tics.

EPIDEMIOLOGY:

  • incidence: 1-10/10,000
  • age of onset:
    • mean age of 6-7 years
    • most develop tics before 13 years of age
  • risk factors:
    • familial - inheritance pattern not established
      • chrom.#: ?18q22.1
      • gene: ?
    • M > F (3:1)
  • comorbid conditions:
    • see "Tic Disorders"

CLINICAL FEATURES:

1. Diagnostic Criteria for Tourette Disorder*

  • A. Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessarily concurrently.
  • B. The tics occur many times a day (usually in bouts), nearly every day or intermittently throughout a period of more than one year.
  • C. The anatomic location, number, frequency, complexity, and severity of the tics change over time.
  • D. Onset before age 21
  • E. Occurrence not exclusively during Psychoactive Substance Intoxication or known CNS disease, such as Huntington's chorea and postviral encephalitis.

     

  • *from DSM-III-R

    • 2. Tic Characteristics

    • see "Tic Disorders"
    • simple motor tics are the most common initial tics
    • motor tics may progress in a rostral-caudal fashion (head & neck to other body parts)
    • spontaneous remission or markedly decrease in symptoms in the 2nd half of adolescence:
      • 30-40% have complete disappearance
      • 25-30% have significant reduction in symptoms
      • in the rest symptoms persist into adulthood
      • no prognostic indicators are available

    INVESTIGATIONS:

    • all tests (CT, MRI, PET, etc) are normal

    MANAGEMENT:

    • see "Tic Disorders"
      • Psychological - Tics and/or Comorbid Problems
      • Pharmological - Tics and/or Comorbid Problems

     

    Pediatric Database - TOURETTE SYNDROME

     

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