A complex neurodevelopmental disorder characterised by motor and vocal tics beginning in childhood.
Part of a larger spectrum of tic disorders, ranging from mild transient tics to debilitating complex tics with behavioural issues and self-injurious behaviours.
The aetiology remains unclear but the condition is familial in most cases.
Diagnosis is based on clinical history. There is no identifiable biological marker.
The course can vary greatly among individuals, but prognosis is often promising, with the majority of patients showing improvement of their tics by young adulthood.
The standard of care is symptomatic medical and behavioural management. Deep-brain stimulation is still experimental. A crucial part of management includes patient, family, teacher, and peer education.
Tourette's syndrome (TS) is a childhood-onset neurodevelopmental disorder characterised by motor and vocal tics and often accompanied by psychiatric problems, such as obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD), among others.  Tic symptoms typically begin in childhood, peak prior to puberty, and attenuate later in adolescence.  
Associate Professor of Psychiatry and Behavioral Sciences
Department of Psychiatry and Behavioral Sciences
Division for Child and Adolescent Psychiatry
Johns Hopkins Medicine
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.
Honorary Clinical Lecturer
Newcastle General Hospital
AB declares that she has no competing interests.
Professor of Neurology, Neurobiology, Anatomy and Pediatrics
Chief Child Neurology
University of Rochester
JM is an author of a number of references cited in this monograph.
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