Tourette Syndrome and Other Tic Disorders Questions & Answers

Updated: May 30, 2019
  • Author: William C Robertson, Jr, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP  more...
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Questions & Answers

Overview

How is Tourette syndrome (TS) characterized?

What are the DSM-5 diagnostic criteria for Tourette disorder?

What are the signs and symptoms of Tourette syndrome (TS)?

What are the DSM-5 diagnostic criteria for persistent (chronic) motor or vocal tic disorder?

What are the DSM-5 diagnostic criteria for provisional tic disorder?

What are effective treatments for tic disorders?

What is Tourette syndrome (TS)?

What is an historical example of Tourette syndrome (TS)?

What is the historical evolution of the understanding of Tourette syndrome (TS) and other tic disorders?

What is the pathophysiology of Tourette syndrome (TS)?

What is the role of biochemistry in the pathophysiology of Tourette syndrome (TS)?

What is the role of dopaminergic function in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

What is the role of genetics in the pathophysiology of Tourette syndrome (TS)?

What is the role of D2-like dopamine-receptors in the pathophysiology of Tourette syndrome (TS)?

What is the role of amphetamines in the pathophysiology of Tourette syndrome (TS)?

What is the role of dopamine breakdown products in the pathophysiology of Tourette syndrome (TS)?

Which pharmacologic fMRI (phMRI) results have increased the understanding of Tourette syndrome (TS) and other tic disorders?

Which findings on functional imaging studies are characteristic of Tourette syndrome (TS) and other tic disorders?

What is the role of metabolism in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

Which findings on functional imaging studies correlate with tic severity or tic suppression in Tourette syndrome (TS) and other tic disorders?

Which findings on functional imaging are related to motor activation in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

Which findings on functional imaging suggest deficient striatal activation in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

What is the role of focal lesions in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

Which neuroanatomic studies support the theory of basal ganglia and frontal cortex involvement in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

Which autopsy findings have increased the understanding of the pathophysiology of Tourette syndrome (TS) and other tic disorders?

What is the role of brain volume in the pathogenesis of Tourette syndrome (TS) and other tic disorders?

What causes involuntary tics in Tourette syndrome (TS)?

What have neuropsychological studies contributed to the understanding of the pathogenesis of Tourette syndrome (TS) and other tic disorders?

What is the role of the timing of tics in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

What is a possible model of tic production in the pathophysiology of Tourette syndrome (TS) and other tic disorders?

What causes Tourette syndrome (TS) and other tic disorders?

What are the genetic causes of Tourette syndrome (TS) and other tic disorders?

What are the nongenetic causes of Tourette syndrome (TS) and other tic disorders?

What is the role of streptococcal infections in the etiology of Tourette syndrome (TS) and other tic disorders?

What is the role of focal lesions in the etiology of Tourette syndrome (TS) and other tic disorders?

What is the role of encephalitis lethargica in the etiology of Tourette syndrome (TS) and other tic disorders?

What is the prevalence of Tourette syndrome (TS) and other tic disorders in the US?

What is the global prevalence of Tourette syndrome (TS) and other tic disorders?

What are the racial predilections of Tourette syndrome (TS) and other tic disorders?

What are the sexual predilections of Tourette syndrome (TS) and other tic disorders?

When is the typical onset of Tourette syndrome (TS) and other tic disorders?

What is the prognosis of Tourette syndrome (TS) and other tic disorders?

Where can patient education materials about Tourette syndrome (TS) and other tic disorders be found?

Presentation

Which clinical history findings are characteristic of Tourette syndrome (TS) and other tic disorders?

What are the diagnostic criteria for Tourette syndrome (TS) (DSM-5 307.23)?

What are the diagnostic criteria for chronic motor or vocal tic disorder (DSM-5 307.22)?

What are the diagnostic criteria for transient tic disorder (DSM-5 307.21)?

What are the Tourette syndrome (TS) Study Group diagnostic criteria for Tourette syndrome (TS) (A-1 or A-2)?

What are the Tourette syndrome (TS) Study Group diagnostic criteria for chronic multiple motor tic or phonic tic disorder (B-1 and B-2)?

What are the Tourette syndrome (TS) Study Group diagnostic criteria for transient tic disorder (D-1 and D-2)?

What are the Tourette syndrome (TS) Study Group diagnostic criteria for nonspecific tic disorder (E-1 and E-2)?

What are the Tourette syndrome (TS) Study Group diagnostic criteria for probable Tourette syndrome (TS) type G?

What are the signs and symptoms of attention deficit–hyperactivity disorder in Tourette syndrome (TS) and other tic disorders?

What is included in the physical exam to evaluate Tourette syndrome (TS) and other tic disorders?

What are the non-tic signs and symptoms of Tourette syndrome (TS) and other tic disorders?

How are tics classified in Tourette syndrome (TS) and other tic disorders?

What are the general features of tics in Tourette syndrome (TS) and other tic disorders?

How are Tourette syndrome (TS) and other tic disorders differentiated from movement disorders?

How is the volition of tics characterized in Tourette syndrome (TS) and other tic disorders?

How are Tourette syndrome (TS) and other tic disorders differentiated from OCD?

Which physical findings are characteristic of sensory tics in Tourette syndrome (TS) and other tic disorders?

Which physical findings are characteristic of dystonic tics Tourette syndrome (TS) and other tic disorders?

Which physical findings are characteristic of coprolalia, in Tourette syndrome (TS) and other tic disorders?

What are the obsessive-compulsive symptoms of Tourette syndrome (TS) and other tic disorders?

DDX

Which conditions are included in the differential diagnoses of Tourette syndrome (TS)?

What are the differential diagnoses for Tourette Syndrome and Other Tic Disorders?

Workup

What is the role of lab testing in the workup of Tourette syndrome (TS) and other tic disorders?

What is the role of serum ceruloplasmin or slit-lamp exam in the workup of Tourette syndrome (TS) and other tic disorders?

What is the role of neuropsychological testing in the workup of Tourette syndrome (TS) and other tic disorders?

What is the role of imaging studies in the workup of Tourette syndrome (TS) and other tic disorders?

Treatment

How are Tourette syndrome (TS) and other tic disorders treated?

Which treatments for tics are effective?

What is the role of dopamine D2 receptor antagonist therapy in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of dopamine agonist therapy in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of habit reversal therapy in the treatment of Tourette syndrome (TS) and other tic disorders?

Which medications have been used in the treatment of tics?

What is the role of guanfacine and clonidine in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of topiramate in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of norepinephrine reuptake inhibitors in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of botulinum toxin injections in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of tetrabenazine in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of baclofen in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of clonazepam in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of levetiracetam in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of SSRIs in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of ondansetron in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of naltrexone/naloxone in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of cannabinoids and nicotine in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of repetitive transcranial magnetic stimulation (rTMS) in the treatment of Tourette syndrome (TS) and other tic disorders?

How are obsessive-compulsive symptoms treated in Tourette syndrome (TS) and other tic disorders?

How is attention deficit–hyperactivity disorder (ADHD) treated in Tourette syndrome (TS) and other tic disorders?

What is the role of divalproex in the treatment of Tourette syndrome (TS) and other tic disorders?

What is the role of stereotactic neurosurgery in the treatment of Tourette syndrome (TS) and other tic disorders?

Which dietary modifications are used in the treatment of Tourette syndrome (TS) and other tic disorders?

What are legal issues that may arise concerning Tourette syndrome (TS) and other tic disorders?

Which specialist consultations are beneficial to patients with Tourette syndrome (TS) and other tic disorders?

Medications

Which factors should be considered in treatment selection decisions for Tourette syndrome (TS) and other tic disorders?

Which medications in the drug class Neuromuscular Blockers are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Which medications in the drug class Benzodiazepines are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Which medications in the drug class Skeletal Muscle Relaxants are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Which medications in the drug class Alpha2-Adrenergic Agonists are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Which medications in the drug class Presynaptic Dopamine-Depleting Agents are used in the treatment of Tourette Syndrome and Other Tic Disorders?

Which medications in the drug class Antipsychotic Agents are used in the treatment of Tourette Syndrome and Other Tic Disorders?