Last reviewed: April 2018
Last updated: January  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • early childhood onset
  • abnormal movements
  • vocal sounds
  • premonitory sensation or 'urge'
  • otherwise normal neurological examination

Other diagnostic factors

  • improvement of symptoms when focused on other tasks
  • worsening of symptoms under stress
  • ritualistic behaviours

Risk factors

  • male sex
  • age 3 to 8 years
  • FHx of TS or tics
  • hx of OCD or ADHD
  • FHx of OCD or ADHD
  • maternal antenatal smoking
  • first trimester maternal stress and severe nausea/vomiting
  • low birth weight

Diagnostic investigations

Investigations to consider

  • brain MRI
  • EEG
  • premonitory urge for tics scale (PUTS)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Director

Associate Professor of Psychiatry and Behavioral Sciences

Department of Psychiatry and Behavioral Sciences

Division for Child and Adolescent Psychiatry

Johns Hopkins Medicine

Baltimore

MD

Disclosures

MAG is a member of the Medical Advisory Board and has received grant support from Cornelia de Lange Syndrome Foundation. MAG has a contract with Palo Alto Health Sciences Inc. for a biofeedback device trial.

Dr Marco Grados would like to gratefully acknowledge Dr Blanca Garcia-Delgar, Dr Barbara J. Coffey, Dr Victoria Chang and Dr Steven Frucht, the previous contributors to this monograph.

Peer reviewers VIEW ALL

Specialised Registrar

Paediatric Neurology

Honorary Clinical Lecturer

Newcastle General Hospital

Newcastle-upon-Tyne

UK

Disclosures

AB declares that she has no competing interests.

Professor of Neurology, Neurobiology, Anatomy and Pediatrics

Chief Child Neurology

University of Rochester

Rochester

NY

Disclosures

JM is an author of a number of references cited in this monograph.

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