Overview of Tourette syndrome

Tourette syndrome is a neuropsychiatric disorder with childhood onset that can cause significant social disability. The disorder is characterised by multiple motor tics and one or more recurrent vocal tics. Tourette syndrome is more common in males than females. Severity typically peaks during adolescence with many children experiencing a substantial reduction in severity by early adulthood. The prevalence of attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD) is greatly increased among children with Tourette syndrome.

Typically, motor tics begin between the ages of 3 and 8 years, with vocal tics appearing several years later. Vocal tics can involve sniffing, grunting, swallowing, coughing, barking, whistling or uttering expletives. Tics occur many times a day, are present over a period longer than 1 year and there is often a waxing and waning pattern of severity, intensity and frequency.

If Tourette syndrome is suspected, refer to a specialist for confirmation of the diagnosis.

Most people with Tourette syndrome have a comorbid psychiatric disorder, which can have a greater impact on the patient than the tics. Effective management of psychiatric comorbidities may reduce tic intensity.

Symptoms of Tourette syndrome should be differentiated from transient simple motor tics of less than 6 months duration, which are common in otherwise healthy children. Advice and support for children and parents is the best management in these circumstances. For the management of tics not associated with Tourette syndrome, see here.

Nonpharmacological treatment is first line for management of Tourette syndrome. If Tourette syndrome is severe or debilitating, consider using pharmacotherapy. While Tourette syndrome improves significantly in adulthood, a minority of adults will continue to have significant symptoms and may require continued treatment.