Tourette Syndrome and Tic Disorders

Tourette syndrome is defined as the presence ofmultiple motor tics and at least 1 vocal tic for morethan 1 year (so long as onset is younger than age18 years and without being due to another cause).(Based on consensus) (25)• Tic disorders are common and occur more frequentlyin boys than in girls. (Based on some researchevidence) (157)• Tics frequently start in early to middle childhoodand vary in type, intensity, and severity over time;most children with tics will have an eventual trendtoward improvement or resolution. (Based onsome research evidence) (15)(16)(158)• Most patients with chronic tic disorders have 1 ormore neuropsychological comorbidities; thesecomorbidities can be more bothersome anddisruptive than the tics themselves. (Based onsome research evidence) (12)• The pathophysiology of tic disorders is incompletelyunderstood but is known to involve the complexinterplay of genetic and environmental factors.(Based on some research evidence) (13)• Prospective, longitudinal, double-blinded, andcontrolled trials have shown no link between thesudden onset or rapid worsening of tics and a groupA b-hemolytic streptococcal infection; most symptomflares were not associated with a streptococcalinfection. (Based on some research evidence)(73)(79)(80)(83)• Assessment of the severity and impact of tics andtic-related comorbidities is important in the ongoingcare of children with tic disorders; when tics are notnegatively affecting the patient, watchful waiting isappropriate. (Based on consensus guidelines) (1)(2)• Tic-suppressing treatment, when warranted, Shouldstart with behavioral therapy recognizing its proveneffectiveness and minimal risk; when behavioraltherapy is ineffective or unavailable, pharmacologictherapy should be offered. (Based on someresearch evidence and consensus guidelines) (1)(22)(107)(125). © 2024 American Academy of Pediatrics. All rights reserved.