Treatment of Tourette's Syndrome

Abstract

den, rapid, involuntary, stereotypical but nonrhythmic movements and vocalizations. Common motor tics include eye blinking, lip lifting, nose wrinkling, and shoulder shrugging. Common vocal tics may include sniffing, grunting, throat clearing, and chirping. According to the DSM-IV-TR, multiple motor or vocal tics must be present at some time during the illness, though not necessarily concurrently. The tics usually occur multiple times per day, nearly every day for at least 1 year, although there can be tic-free periods lasting up to 3 months. TS should be distinguished from other movement disorders (e.g., stereotypies, Huntington chorea, Sydenham chorea, epilepsy, myoclonus, spasmodic torticollis, postviral encephalitis). The prevalence of TS among 13and 14-year-olds varies widely, with estimates ranging from 31–157/1000 children in European and Asian samples. In contrast, the prevalence of simple tics in the general population ranges from 6%–20% of all children. To be diagnosed with TS, patients must have tic onset before age 18. Developmentally, most simple motor tics begin after the age of 3 and reach their peak around age 5. Children who go on to develop TS will have their motor tics continue through age 5 with frequency peaking between ages 9 and 12, typically subsiding thereafter. Vocal tics tend to have a later onset, usually occurring by age 11. Researchers agree that the severity of TS in most individuals begins to wane during the early 20s. Patients with persistent TS will experience a waxing and waning pattern of After reading this article, the practitioner should be able to: