title: The early course of the Tourette's syndrome clinical spectrum.
abstract: We retrospectively studied 101 children with Tourette's syndrome to characterize the early course of illness and associated behavioral disturbances of attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), disruptive behavior (DB), and school problems (SP). For patients without ADHD (45%), OCD (50%), DB (67%), or SP (52%) at the time of initial evaluation, 13% developed ADHD, 8% OCD, 28% DB, and 25% SP during the observation period of 1.6 +/- 1.3 years (range, 0.5 to 7 years). For patients with behavioral disturbances initially, the problems were controlled or resolved for many over time and with therapy: ADHD, 46%; OCD, 47%; DB, 50%; and SP, 67%. Medication changes, assessed after a drug adjustment period between the initial and first follow-up visits (6 +/- 6 months), showed that drug dosages remained largely unchanged and few patients required the addition of new drugs: tic suppressants, 10%; anti-obsessional agents, 5%; and stimulants, 12%. Tic suppressants were withdrawn from 12%.
authors.affiliation: Department of Neurology, University of Rochester School of Medicine, NY 14642.
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.forename: P G
authors.initials: PG
authors.lastname: Como
authors.forename: L
authors.initials: L
authors.lastname: Cui
authors.forename: R
authors.initials: R
authors.lastname: Kurlan
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D009771:Obsessive-Compulsive Disorder / Q000150:complications; D012189:Retrospective Studies; D012574:Schools; D005879:Tourette Syndrome / Q000150:complications* / Q000188:drug therapy / Q000523:psychology