Tourette Syndrome

Question 1

What is characteristic in Tourettes?

Answer 1

motor and phonic tics

Question 2

What disorders is Tourettes often accompanied w/?

Answer 2

Psych disorders! (60%)

• OCD
• ADHD

Question 3

When does Tourettes present, who is it MC in?

Answer 3

Onset during childhood
(~6 year old onset of tics)
MC in males 4:1

Question 4

What is premonitory sensation or urge involved in tics?

Answer 4

• feeling of inner discomfort (“burning or tension”) prior to performing the tics
• unexplainable urge or impulse that builds prior to performing the tic

Question 5

How is Tourettes dx?

Answer 5

Presence of motor and phonic tics for more than 1 year, prior to 18 years old

Do dx studies when:

• Brain MRI is abnormality detected on neuro exam
• EEG if need to evaluate for possible seizure activity

Question 6

Treatment for Tourettes for pts w/ mild tics, non disabling?

Answer 6

• if comorbid psych disorder, treat that first

- Comprehensive behavioral intervention of tics (CIBT) if 1ST LINE for those w/ mild tics that are non-disabling

Question 7

Tx for pts w/ Tourettes w/ moderate-severe tics?

Answer 7

• Clonidine or guanfacine (alpha-adrenergic agonists)= 1ST LINE
• Botulinum toxin injection can be used for focal motor tics