Pediatric Tourette Syndrome Differential Diagnoses

Updated: Jun 18, 2020
  • Author: Shikha Verma, MD, FAPA; Chief Editor: Caroly Pataki, MD  more...
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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 TS can co-occur with multiple behavioral disorders, psychiatric diagnoses to consider are depression, obsessive-compulsive disorder, and personality disorders.

Differential Diagnoses