Pediatric Tourette Syndrome Workup

Updated: Mar 25, 2015
  • Author: Jason S Hawley, MD; Chief Editor: Eduardo Dunayevich, MD  more...
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Workup

Approach Considerations

Tourette syndrome (TS) is a clinical diagnosis; therefore, no specific laboratory or genetic tests exist to help establish the diagnosis. Routine community based neuroimaging studies (CT and MRI) are normal in patients with TS. The keys to diagnosis are recognition and an index of suspicion.

Neuroimaging studies performed on a research basis have yielded subtle abnormalities that may give clues to understanding the pathophysiology of TS. Children and adults with TS have reduced caudate volumes compared with controls. Moreover, recent studies have suggested that the degree of volume reduction within the caudate nucleus correlates with the severity of tics and obsessive-compulsive disorder (OCD). [12]

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Functional Magnetic Resonance Imaging

Event-related functional MRI studies of patients with tics have indicated that paralimbic and sensory association areas are critically implicated in tic generation, similar to movements triggered internally by unpleasant sensations, as has been shown for pain or itching.

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Positron-Emission Tomography

Positron-emission tomography (PET) studies have also shown increased activity in sensomotor, paralimbic, language, and frontal subcortical regions. This activity was event-related to motor and phonic tics, as well as the compulsions to perform these behaviors.

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