Tics and Tourette syndrome

Abstract

Tics and Tourette affect 1% of the childhood population and are characterised by chronic (more than 12 months) or motor and vocal tics. Tourette is considered a neurodevelopmental disorder and commonly co-exists with ADHD, OCD and also other emotional disorders. Regarding aetiology, although a genetic contribution is manifest, it is clear that the genomics of Tourette is extremely complex with 100 s of genes providing small contibrutions. It is increasingly clear that environmental factors play a significant role in disease expression, and there is increasing interest in the role of maternal factors in pregnancy and early life factors that increase the expression of disease, which is also true for other neurodevelopmental disodrers such as ADHD and autism. A therapeutic approach to Tourette should involve defining comorbidity, functional impairment and therapeutic priorities. Often psychoeducation is all that is required in many patients with tics and low level comorbid impairments. However in children with significant impairments, treatment of the ADHD, OCD or tics should be considered using psychological, behavioural or medical strategies.