Pediatric Tourette Syndrome Differential Diagnoses

  • Author: Jason S Hawley, MD; Chief Editor: Eduardo Dunayevich, MD   more...
 
Updated: Feb 7, 2012
 
 

Diagnostic Considerations

Patients with Tourette syndrome (TS) and their families may not necessarily alert the practitioner regarding the symptoms. The excessive movements may be dismissed as twitchiness or anxiety and not necessarily considered a disease.

The practitioner could potentially diagnose tics as chorea or myoclonus, and initiate an unnecessary work up to evaluate these conditions. Phonic tics, such as throat clearing, sniffing or cough, may be mistaken for allergies or asthma.

TS should be differentiated from transient tic disorder of childhood, which is similar to TS but lasts for less than a year. Chronic multiple tic disorder has great similarity to TS but remains present in adulthood. Chronic single tic disorder is a motor or vocal tic in adulthood.

Other neurologic diagnoses to consider are the following:

  • Tuberous sclerosis
  • Neuroacanthocytosis
  • Dystonia
  • Hallervorden-Spatz disease
  • Neurofibromatosis type 1
  • Chromosomal disorders
  • Sydenham chorea
  • Motor restlessness
  • Akathisia
  • Excessive startle

Since patients with TS can have multiple behavioral disorders, psychiatric diagnoses to consider are depression, obsessive-compulsive disorder, and personality disorders.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Jason S Hawley, MD  Chief of Neurology, Carl R Darnall Army Medical Center

Jason S Hawley, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Chief Editor

Eduardo Dunayevich, MD  Adjunct Assistant Professor, Department of Psychiatry, University of Cincinnati; Clinical Research Physician, Neuroscience, Lilly Research Laboratories

Eduardo Dunayevich, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

Additional Contributors

Sharette K Gray, MD Chief of Outpatient Psychiatry, Carl R Darnall Army Medical Center

Sharette K Gray, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Mark E Landau, MD Neurology Program Director, National Capital Consortium, Associate Professor, Uniformed Services University of the Health Science, Neurophysiology Section, Department of Neurology, Walter Reed Army Medical Center

Mark E Landau, MD is a member of the following medical societies: American Academy of Neurology and American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Jennifer S Morse, MD Associate Medical Director, Optum Health

Jennifer S Morse, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, Aerospace Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Emad Soliman, MD, MSc Consulting Staff, Department of Neurology, St John's Riverside Hospital

Emad Soliman, MD, MSc is a member of the following medical societies: American Academy of Neurology and American Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

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