Tourette Syndrome - Neuro

Question 1

Diagnosis

Answer 1

-Motor and Vocal tics
-For 1 year
+/- Impairment

2/3 Self-diagnosed
-No longer need continuous tics to qualify. -Ok to have periods of months without tics, so long as they keep coming back over one year’s time.

Question 2

Provisional tic disorder

Answer 2

Tic have been present less than 12 months since first tic onset

Question 3

Course

Answer 3

• Starts in young children
• Starts with motor tics, then vocal
• Starts in the head and face, then in the body
• Starts with simple tics, then more complex tics
• Peak severity is in early to mid teens
• Development of comorbid conditions is usually later except for ADHD
• Small percentage have a poor outcome from tics

Question 4

Co-occurring Problems

Answer 4

• Obsessive compulsive disorder
• ADHD
• Anxiety
• Depression
• Disruptive behavioral disorders
• Anxiety
• Mood
• Impulse and behavior control
• Problems with learning

Question 5

Tic Suppression

Answer 5

Small – Commonly used 
-Clonidine - short acting
-Guanfacine - longer acting
Medium – Not commonly used 
-TCAs
-Benzodiazepines
Large- 
-antipsychotics
-Botulinum Toxin: Single muscle, Long acting, Reversible