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Tourette's Syndrome (cont.)

When to Seek Medical Care for Tourette's

The development of tics in an otherwise healthy child is an indication for consultation with a pediatrician.

If the tics do not improve or if there is any doubt about the diagnosis, the pediatrician probably will send the child to a specialist. In this case a professional with special knowledge in Tourette's syndrome would be the best choice. In some large academic centers it is possible to find specialized clinics, but since Tourette's syndrome is not common, this most likely is not a choice for most individuals.

Pediatric neurologists often specialize in Tourette's syndrome, and this would probably be the best choice for diagnostic opinions and treatment.

Depending upon the severity of the associated conditions the patient might need psychiatric consultation to help with appropriate treatment options for severe co-morbid conditions (ADHD, OCD, LD, mood disorder, severe aggression, sleep difficulties).

Depending upon the severity of the psychological problems, a consultation with a psychologist might be needed. Also, depending upon the severity of any associated learning disorders, a special individualized education plan (IEP) might be necessary.

Questions to Ask the Doctor about Tourette's

The first question should be the confirmation of the diagnosis. Since this is a chronic condition, and the doctor will be involved with the patient for a long period of time, it is important to know if the doctor has experience in dealing with Tourette's syndrome.

Next, it is important to know if the patient can benefit from the use of medications, and if so, how long the medication(s) should be used. It is also essential to ask about any possible side effects of the medications, for example if the medications are safe to take in pregnancy or if it is safe to drive while taking the medication(s).

Exams and Tests for Tourette's

The diagnosis of Tourette's syndrome is based on clinical information and a physical examination.

At the present time there is no test that will confirm the diagnosis. However, the physician might recommend some tests in certain cases just to rule out other possible diseases.

The Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV), a common source of reference for diagnostic purposes, established as a criteria for the diagnosis of Tourette's syndrome:

  • the presence of both multiple motor tics and one or more phonic tics that might be present at some time, although not necessarily concurrently.
  • The tics must occur many times a day (usually in bouts) nearly every day or intermittently over more than a year, during which time there must not have been a tic-free period of more that three consecutive months. The onset occurs before the age of 18 years. Also there may not be other explanation for the tics.

When the patient meets these criteria it is usually not necessary to perform other tests.

There are some scales, such as the Yale Global Tic Severity Scale (YGTSS), that may be helpful to determine the level of impairment and to evaluate treatment options.

Neuropsychological testing may be indicated only for children with school problems, otherwise this is not useful.

Medically Reviewed by a Doctor on 12/30/2015
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