Tourette’s Syndrome (GT)/Gilles de la Tourette’s Syndrome (GTS):
Chronic neurobehavioural disorder associated with tics and behavioural abnormalities (most common cause of tics). M 3x>F. Prevalence of 0.05%. Onset usually between 3-21 years (50% before age 7)– often sudden. Autosomal dominant (variable penetration).
Tics – usually begins with simple motor tics (eg blinks, head jerks, shoulder shrugs), vocal (eg inarticulate noises or sounds or meaningful words or phrases; 8-25% obscene words). Later progresses to complex tics (eg facial grimacing, hand shaking, kicking); most tics diminish after adolescence
Behaviours – up to 70% have obsessive compulsive disorder (OCD) – may be a genetic link; attention deficit hyperactivity disorder (ADHD) is also common.
Criteria for diagnosis (Tourette Syndrome Classification Study Group):
the presence of multiple motor tics and one or more vocal tics at some time during the course of the disorder that are:
unexplained by other medical conditions
directly observed by a reliable examiner or recorded (eg videotape)
the occurrence of tic episodes several times daily, almost every day, or periodically during a period of more than one year
changes in the type, severity, complexity, frequency, and anatomical location of tics during the course of the disorder
symptoms onset before age 21
Management – if tics causing social problems haloperidol; simple tics may respond to benzodiazepines; biofeedback and relaxation techniques may help some