Tourette syndrome: clinical and psychological aspects of 250 cases.
Tourette syndrome is a common hereditary neuropsychiatric disorder consisting of multiple tics and vocal noises. We summarize here clinical aspects of 250 consecutive cases seen over a period of 3 years. The sex ratio was four males to one female, and the mean age of onset was 6.9 years. Only 10% were Jewish, indicating that it is not more prevalent in Ashkenazi Jews. Only 33% had compulsive swearing (coprolalia), indicating that this is not necessary for the diagnosis. The most frequent initial symptoms were rapid eye-blinking, facial grimacing, and throat-clearing. In this series, it was clear that Tourette syndrome is a psychiatric as well as a neurological disorder. Significant discipline problems and/or problems with anger and violence occurred in 61%, and 54% had attention-deficit disorder with hyperactivity. Some degree of exhibitionism was present in 15.9% of males and 6.1% of females. Obsessive-compulsive behavior was seen in 32%. Other than tics and vocal noises, the most common parental complaints were of short temper and everything being a confrontation. There were no significant clinical differences between familial and sporadic cases. Whenever a child presents with a learning disorder, attention-deficit disorder, or significant discipline or emotional problems, the parents should be questioned about the presence of tics or vocal noises in the patient and other family members.
D000293:Adolescent; D000367:Age Factors; D000374:Aggression; D000786:Anger; D002648:Child; D002675:Child, Preschool; D003192:Compulsive Behavior; D003951:Diagnostic Errors; D005084:Exhibitionism; D005260:Female; D006801:Humans; D007585:Jews; D007859:Learning Disabilities; D008297:Male; D012652:Self Mutilation; D013981:Tic Disorders; D005879:Tourette Syndrome / Q000175:diagnosis / Q000235:genetics / Q000523:psychology / Q000628:therapy; D014754:Violence