Tourette syndrome
Alerts and Notices
Synopsis
Symptoms usually manifest before age 18 and occur in the setting of a normal mental status and clear sensorium. Motor tics most commonly involve the face but can also involve the arms, legs, or trunk. Throat clearing is the most common vocal tic, but other vocalizations including grunting, sniffing, or coprolalia may be present. The movements are partially voluntarily controlled; they may be temporarily suppressible, but afterward, on release, they are often more pronounced. There is often a premonitory urge or sensation prior to the movement.
The severity and extent of the tics can fluctuate greatly over months and years, with periods of relative quiescence. Tics may disappear in adulthood. Inquiry should be made regarding childhood habits, including persistent throat clearing, humming, or twitches. Attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and anxiety are common comorbidities of the disease.
Codes
ICD10CM:F95.2 – Tourette's disorder
SNOMEDCT:
5158005 – Gilles de la Tourette's syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Stereotypies
- Myoclonus
- Obsessive-compulsive disorder
- Huntington disease (early)
- Wilson disease
- Neuroacanthocytosis
- Drug-induced involuntary movements (see drug-induced dystonia)
- Functional movement disorder
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Management Pearls
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Therapy
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References
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Last Reviewed:01/02/2019
Last Updated:01/25/2022
Last Updated:01/25/2022