Clinical assessment of Tourette syndrome and tic disorders

Abstract

Tourette syndrome (TS) is a neuropsychiatric disorder involving multiple motor and phonic tics. Tics, which usually begin between the ages of 6 and 8, are sudden, rapid, stereotyped, and apparently purposeless movements or sounds that involve discrete muscle groups. Individuals with TS experience a variety of different sensory phenomena, including premonitory urges prior to tics and somatic hypersensitivity due to impaired sensorimotor gating. In addition to other conditions, stress, anxiety, fatigue, or other heightened emotional states tend to exacerbate tics, while relaxation, playing sports, and focused concentration on a specific task tend to alleviate tic symptoms. Ninety percent of children with TS also have comorbid conditions, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or an impulse control disorder. These disorders often cause more problems for the child both at home and at school than tics do alone. Proper diagnosis and treatment of TS involves appropriate evaluation and recognition, not only of tics, but also of these associated conditions.

Copyright © 2013. Published by Elsevier Ltd.

Figures

Figure 1. Average Tic Severity from Age 2–18 years

Adapted with permission from (Leckman, Zhang et al. 1998)

Figure 2. Clinical Course of Tourette syndrome and Associated Conditions

Figure depicts severity of tics and comorbid conditions associated with Tourette syndrome. Width of bars correspond to severity of symptoms. Adapted with permission from (Leckman 2002).