Tics.
OBJECTIVE
This paper reviews the recent literature concerning Tourette syndrome and related disorders.


RESULTS
Tourette syndrome is a common disorder in children and adolescents, with an established association with attention deficit hyperactivity disorder, obsessive compulsive disorder, and a number of other psychiatric disorders. Both autoimmune and genetic mechanisms are implicated in the pathophysiology of the syndrome, while neuroimaging studies have identified abnormalities in the composition of the basal ganglia and frontal lobe white matter, as well as alterations in dopaminergic activity. When necessary, treatment of tics can be successful with neuroleptics and alpha-2-adrenergic agonists. The use of stimulants in children with Tourette syndrome and comorbid attention deficit hyperactivity disorder does not appear to worsen tics.


CONCLUSIONS
As a result of the recent literature, clinicians can feel comfortable treating children with co-morbid attention deficit hyperactivity disorder and Tourette syndrome with stimulant medications. It has also been established that transient tics are very common in children, and for the most part, non-disabling. In those children with persistent tics, behavioural disorders are associated which may impair success in school and psychosocial functioning. Clinicians have a number of therapeutic options, with recent double-blinded randomized trials of clonidine, risperidone, and desipramine showing benefit. Scientists continue to search for the cause of Tourette syndrome.
Pringsheim
Tamara
T
Neurology Program, University of Toronto, Toronto, Ontario M5T 2S8, Canada. tamara.pringsheim@utoronto.ca
Davenport
William Jeptha
WJ
Lang
Anthony
A
D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D006801:Humans; D013981:Tic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D014055:Tomography, Emission-Computed; D005879:Tourette Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics
D000697:Central Nervous System Stimulants