Tourette syndrome and tic disorders: overview and practical guide to diagnosis and treatment.

OBJECTIVE: This is a practical review of Tourette syndrome, including phenomenology, natural history, and state-of-the-art assessment and treatment.

METHOD: Computerized literature searches were conducted under the keywords Tourette syndrome,tics, and children-adolescents.

RESULTS: Studies have documented the natural history of Tourette syndrome and its frequent co-occurrence with attention problems, obsessive-compulsive disorder (OCD), and a range of other mood and anxiety disorders, which are often of primary concern to patients and their families. Proper diagnosis and education are often very helpful for patients, parents, siblings, teachers, and peers. When necessary, available anti-tic treatments have proven efficacious. First-line options include the alpha adrenergic agents and the atypical neuroleptics, as well as behavioral interventions such as habit reversal.

CONCLUSIONS: The study of tics and Tourette symdrome has led to the development of several pathophysiological models and helped in the development of management options. However, fully explanatory models are still needed that would allow for accurate prognostication in the course of illness and the development of improved treatments.