Materiały źródłowe

• #1 An Update on the Diagnosis and Management of Tic Disorders

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10789408/

  Tic disorders (TDs) are a group of common neuropsychiatric disorders of childhood and adolescence. […] TD is a clinical diagnosis based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. […] TDs are more prevalent in children than in adults and in males than in females. […] The prevalence of TS was 0.77%, four times higher in boys as compared to girls. […] A patient’s susceptibility to develop TD may result from a complex interaction between various genetic, environmental, and immunological factors. […] Dysregulation in the cortico-striato-pallido-thalamo-cortical network is the most plausible pathophysiology resulting in TD. […] TD is a clinical diagnosis. It is based on clinical features and findings on neurological examination, especially the identification of tic phenomenology.

• #1 Diagnosis for Tic Disorders | Tourette Syndrome | CDC

  https://www.cdc.gov/tourette-syndrome/diagnosis/index.html

  There are three main types of tic disorders. […] Health professionals consider the type of tic present and how long the symptoms have lasted to diagnosis a specific tic disorder. […] The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) is used by health professionals to help diagnose tic disorders. […] Three tic disorders are included in the DSM-5-TR: Tourette syndrome (TS, sometimes called Tourette disorder), Persistent (sometimes called chronic) motor or vocal tic disorder, Provisional tic disorder. […] The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or a combination of both), and how long the symptoms have lasted. […] To be diagnosed with TS, a person must have two or more motor tics and at least one vocal tic, have had tics for at least a year, have tics that begin before age 18 years, and have symptoms that are not due to taking medicine or other drugs or due to having another medical condition.

• #2

  https://journals.lww.com/annalsofian/fulltext/2023/26060/an_update_on_the_diagnosis_and_management_of_tic.6.aspx

  Tic disorders (TDs) are a group of common neuropsychiatric disorders of childhood and adolescence. TD is a clinical diagnosis based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. TDs are more prevalent in children than in adults and in males than in females. The prevalence of TS was 0.77%, four times higher in boys as compared to girls. A patients susceptibility to develop TD may result from a complex interaction between various genetic, environmental, and immunological factors. Dysregulation in the cortico-striato-pallido-thalamo-cortical (CSPTC) network is the most plausible pathophysiology resulting in TD. TD is a clinical diagnosis. It is based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. The presence of motor and/or vocal tics, duration of illness, age at tic onset, and absence of secondary causes are important to diagnose different types of TD as per DSM-V criteria. Primary TD is a clinical diagnosis, and electroencephalogram, neuroimaging, psychological evaluation, and lab tests are mainly used to diagnose comorbidities or exclude other disorders, including secondary causes of TD. Patients with TD usually do not need specific treatment if tics are not distressing.

• #2 Diagnosing Tic Disorders | Tourette Syndrome | NCBDDD | CDC

  http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/ncbddd/tourette/diagnosis.html

  The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is used by health professionals to help diagnose tic disorders. […] Three tic disorders are included in the DSM-5: Tourettes disorder (also called Tourette Syndrome [TS]), Persistent (also called chronic) motor or vocal tic disorder, and Provisional tic disorder. […] For a person to be diagnosed with TS, he or she must have two or more motor tics and at least one vocal tic, have had tics for at least a year, have tics that begin before he or she is 18 years of age, and have symptoms that are not due to taking medicine or other drugs or due to having another medical condition. […] For a person to be diagnosed with a persistent tic disorder, he or she must have one or more motor tics or vocal tics, have tics that occur many times a day nearly every day or on and off throughout a period of more than a year, have tics that start before he or she is 18 years of age, have symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics, and not have been diagnosed with TS.

• #3 Tic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/970

  Tics are brief, sudden, repetitive movements and/or sounds that increase with stress, anxiety, transitions, or excitement. […] Tics occur most commonly in children and adolescents, with boys more frequently affected than girls. […] Tics are often intermittent and mild in children and may not require treatment. Treatment is indicated only for patients whose tics are interfering with activities of daily living or social interactions, or who experience significant tic-related physical pain. […] Tics increase with stress, anxiety, transitions, and excitement, and decrease with distraction. […] Tic disorders may be primary (idiopathic or inherited) or secondary to certain conditions (e.g., head trauma, encephalitis). […] Key diagnostic factors include the presence of risk factors, observed tics, premonitory sensation, ability to suppress tics, symptoms may improve when distracted, and otherwise normal neurological examination.

• #3 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  Tic disorders are a spectrum of neurological conditions that cause you to perform tics. Tics and their associated symptoms may range from mild to severe. In many cases, tics are mild and don’t require treatment. Tics often go away as children get older. In other cases, treatment is necessary to manage tics and other health conditions that occur with them. […] There are three main types of tic disorders. They differ from each other based on the type of tics and how long symptoms have lasted. Tic disorders include provisional tic disorder, persistent (chronic) tic disorder and Tourette syndrome. […] People with provisional tic disorder, or transient tic disorder, have motor or vocal tics (one or both) for less than one year. This is the most common type of tic disorder. It may affect up to 10% of children in their early school years.

• #4 Diagnosis for Tic Disorders | Tourette Syndrome | CDC

  https://www.cdc.gov/tourette-syndrome/diagnosis/index.html

  To be diagnosed with a persistent tic disorder, a person must have one or more motor tics or vocal tics, have tics that occur many times a day nearly every day or on and off throughout a period of more than a year, have tics that start before age 18 years, and have symptoms that are not due to taking medicine or other drugs. […] To be diagnosed with a provisional tic disorder, a person must have one or more motor tics or vocal tics, have been present for no longer than 12 months in a row, have tics that start before age 18 years, and have symptoms that are not due to taking medicine or other drugs. […] In some children, tics may suddenly appear, or suddenly become worse, following a streptococcal (strep) infection. […] The best first step is usually to talk to a healthcare provider who is familiar with tics and get a thorough assessment.

• #5 Tic disorders: Causes, types, and diagnosis

  https://www.medicalnewstoday.com/articles/317950

  Tic disorders are diagnosed based on signs and symptoms. The child must be under 18 at the onset of symptoms for a tic disorder to be diagnosed. Also, the symptoms must not be caused by other medical conditions or drugs. […] The criteria used to diagnose transient tic disorder include the presence of one or more tics, occurring for less than 12 months in a row. […] Chronic motor or vocal tic disorders are diagnosed if one or more tics have occurred almost daily for 12 months or more. […] People with a chronic tic disorder that is not TS, will experience either motor tics or vocal tics, but not both. […] TS is based on the presence of both motor and vocal tics, occurring almost daily for 12 months or more. […] Most children are under the age of 11 when they are diagnosed. Other behavioral concerns are often present, as well. […] To rule out other causes of tics, a doctor may suggest blood tests, MRI scans or other imaging.

• #6 Tourette Syndrome and Other Tic Disorders: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1182258-overview

  Tourette syndrome (TS) is a common genetic neurological disorder characterized by chronic motor and vocal tics beginning before adulthood. […] The specific DSM-5 criteria for Tourettes disorder are as follows: Both multiple motor and 1 or more vocal tics have been present at some time during the illness, though not necessarily concurrently. […] The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset. […] The onset is before age 18 years. […] The disturbance is not due to the direct physiologic effects of a substance (eg, cocaine) or a general medical condition (eg, Huntington disease or postviral encephalitis). […] The specific DSM-5 criteria for persistent (chronic) motor or vocal tic disorder are as follows: Single or multiple motor or vocal tics (eg, sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalizations), but not both, have been present at some time during the illness.

• #7 Diagnosis – Tourette Association of America

  https://tourette.org/about-tourette/overview/diagnosis/

  The first symptoms of Tourette Syndrome (TS) usually are involuntary movements (tics) of the face, arms, limbs or trunk. These tics are frequent, repetitive and rapid. For a person to be diagnosed with TS pursuant to DSM-5 criteria, they must: have both multiple motor tics (for example, blinking or shrugging the shoulders) and vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time. […] have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on. […] have tics that begin before they are 18 years of age. […] have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis). […] However, for a confirmed diagnosis of TS both involuntary movements and vocalizations must be present.

• #8 Medical Diagnosis – Tourette Association of America

  https://tourette.org/about-tourette/overview/diagnosis/medical-diagnosis/

  Tourette Syndrome is part of a spectrum of neurological disorders that typically first appear in childhood. The first symptoms usually are involuntary movements (tics) of the face, arms, limbs or trunk. […] For a person to be diagnosed with TS pursuant to DSM-5 criteria he or she must: have both multiple motor tics (for example, blinking or shrugging the shoulders) and vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time. […] have tics that begin before he or she is 18 years of age. […] have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis). […] However, for a confirmed diagnosis of TS both involuntary movements and vocalizations must be present.

• #9 Diagnosing Tourette Disorder | NYU Langone Health

  https://nyulangone.org/conditions/tourette-disorder/diagnosis

  Tourette disorder is a chronic disorder of the nervous system that starts in childhood and causes involuntary motor and vocal tics […] In people with Tourette disorder, tics start before age 18, happen daily, and range from mild to severe. […] A diagnosis of Tourette disorder is made when the person has two or more motor tics and at least one vocal tic even if these do not happen at the same time. Tics must persist for more than one year. […] Because other psychiatric disorders or certain medications can cause symptoms that mimic those of Tourette disorder, a thorough evaluation is needed to ensure an accurate diagnosis. […] Our experts use the information from these medical evaluations and imaging tests to develop a personalized plan to manage tics and other symptoms of Tourette disorder and to improve quality of life.

• #10 Tourette syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

  There’s no specific test that can diagnose Tourette syndrome. The diagnosis is based on the history of your signs and symptoms. […] The criteria used to diagnose Tourette syndrome include: […] A diagnosis of Tourette syndrome might be overlooked because the signs can mimic other conditions. Eye blinking might be initially associated with vision problems, or sniffling attributed to allergies. […] Both motor and vocal tics can be caused by conditions other than Tourette syndrome. To rule out other causes of tics, your doctor might recommend:

• #11 An Update on the Diagnosis and Management of Tic Disorders

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10789408/

  The presence of motor and/or vocal tics, duration of illness, age at tic onset, and absence of secondary causes are important to diagnose different types of TD as per DSM-V criteria. […] Tics should be differentiated from other neurological conditions such as dystonia, chorea, athetosis, hamiballismus, seizures, myoclonus, tremor, and functional tics. […] Primary TD is a clinical diagnosis, and electroencephalogram, neuroimaging, psychological evaluation, and lab tests are mainly used to diagnose comorbidities or exclude other disorders, including secondary causes of TD. […] Patients with TD usually do not need specific treatment if tics are not distressing. […] The management of TD has been addressed by various consensus guidelines, including European Clinical Guidelines for TS and TD, Canadian guidelines for the evidence-based treatment of TD, and the most recent American Academy of Neurology Practice Guideline Recommendations for Treatment of TS and Chronic TD.

• #12 Transient Tic Disorder: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/neurological-health/transient-tic-disorder

  There is no foolproof test to diagnose transient tic disorder and other tic disorders. […] Your doctor may need to order other tests, such as brain CT scans and blood tests, to determine if the tics are a symptom of something more serious, such as Huntington disease. […] You must meet all the following conditions to receive a transient tic disorder diagnosis: […] Tics must occur for less than 12 months in a row. […] Tics must start before 18 years of age. […] Symptoms must not be a result of medication or drugs, or of another medical condition such as Huntington disease or post-viral encephalitis. […] You must not have Tourette syndrome or any other chronic motor or vocal tic disorder.

• #13 Tourette’s syndrome

  https://www.nhs.uk/conditions/tourettes-syndrome/

  Tics are the main symptom of Tourette’s syndrome. […] You can be diagnosed with Tourette’s syndrome if you’ve had several tics for at least a year. […] Getting a firm diagnosis can help you and others understand your condition better, and give you access to the right kind of treatment and support. […] There’s no single test for Tourette’s syndrome. Tests and scans, such as an MRI scan, may be used to rule out other conditions.

• #14 How is Tourette Syndrome Diagnosed? – Stony Brook Medicine Health News

  https://health.stonybrookmedicine.edu/how-is-tourette-syndrome-diagnosed/

  Tourette Syndrome is most commonly diagnosed in childhood, often between ages 5 and 10. […] Diagnosing Tourette Syndrome involves careful evaluation by a healthcare professional, usually a pediatrician, neurologist, psychiatrist or other mental healthcare provider. […] There is no blood, lab or imaging test needed for diagnosis of for Tourette Syndrome. A diagnosis is typically based on clinical observation and criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is a guide used by healthcare professionals to diagnose and classify mental health conditions. […] Key diagnostic criteria for Tourette Syndrome include: Presence of both motor and vocal tics: An individual with Tourette Syndrome must have at least one vocal tic and two motor tics; these tics do not need to occur at the same time.

• #15

  https://www.nhs.uk/conditions/tics/

  Tics are fast, repetitive muscle movements that result in sudden and difficult to control body jolts or sounds. […] A GP should be able to diagnose a tic from a description of it and, if possible, seeing it. Recording a short video can be helpful, but be careful not to draw too much attention to the tic while filming as this can make it worse.

• #16 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  People with persistent (chronic) tic disorder have motor or vocal tics (not both) for more than one year. Persistent tic disorder affects less than 1% of school-age children. […] People with Tourette syndrome have motor and vocal tics (both) for more than one year. This is the most severe type of tic disorder. […] Tic disorders are fairly common. Researchers estimate that 1 out of every 50 children has Tourette syndrome or another tic disorder. […] Your child’s healthcare provider will perform a physical exam and evaluate their symptoms. If possible, it’s helpful to bring along a video or two of your child performing their tics so their provider can see what exactly your child is experiencing. […] Based on what type of tics and their duration, your child’s provider may make a diagnosis of a certain type of tic disorder. Your child’s provider may also evaluate them for other disorders that often accompany tics, like ADHD and OCD.

• #17 Tourette’s Syndrome and Tics Treatment & Diagnosis | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/tics-tourettes-syndrome/

  Tourettes syndrome is a clinical diagnosis, meaning that it is based on the symptoms and signs on examination. […] Various rating scales can be employed to quantify the severity of the condition, including the Yale Global Tic Severity Scale, which assesses the frequency, complexity and number of tics, as well as the degree to which they interfere with daily life. […] There are no blood tests for Tourettes, nor MRI findings, but research is being done on genetic etiologies of Tourettes syndrome since a family history is common and there is often overlap with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD).

• #18 How is Tourette Syndrome Diagnosed? – Stony Brook Medicine Health News

  https://health.stonybrookmedicine.edu/how-is-tourette-syndrome-diagnosed/

  Duration of one year: Symptoms must have been present for at least one year. […] Age of onset: Symptoms must begin before age 18. […] No other underlying cause: Symptoms cannot be attributed to another condition (such as OCD), or medication or substance use. […] Doctors often rely on observation of tics during a meeting with a patient. […] Brain scans like MRIs or CT scans do not diagnose TS, as the condition does not show structural abnormalities in the brain. […] Receiving a Tourette Syndrome diagnosis can sometimes bring relief to families by providing an explanation for a child’s behavior.

• #19 Tic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/970

  Other diagnostic factors include symptoms worse with stress, anxiety, excitement, or transitions, variable severity over time, and symptoms of comorbid psychiatric disorder. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include MRI brain with and without contrast, electroencephalogram, and cerebrospinal fluid analysis (lumbar puncture).

• #20 Tic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/970

  Other diagnostic factors include symptoms worse with stress, anxiety, excitement, or transitions, variable severity over time, and symptoms of comorbid psychiatric disorder. […] 1st investigations to order include clinical diagnosis. […] Investigations to consider include MRI brain with and without contrast, electroencephalogram, and cerebrospinal fluid analysis (lumbar puncture).

• #21 Tic – Wikipedia

  https://en.wikipedia.org/wiki/Tic

  Although tic disorders are commonly considered to be childhood syndromes, tics occasionally develop during adulthood; adult-onset tics often have a secondary cause. Tics that begin after the age of 18 are not diagnosed as Tourette’s syndrome, but may be diagnosed as an „other specified” or „unspecified” tic disorder. […] Tests may be ordered as necessary to rule out other conditions: For example, when diagnostic confusion between tics and seizure activity exists, an EEG may be ordered, or symptoms may indicate that an MRI is needed to rule out brain abnormalities. TSH levels can be measured to rule out hypothyroidism, which can be a cause of tics. Brain imaging studies are not usually warranted.

• #22 An Update on the Diagnosis and Management of Tic Disorders

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10789408/

  The presence of motor and/or vocal tics, duration of illness, age at tic onset, and absence of secondary causes are important to diagnose different types of TD as per DSM-V criteria. […] Tics should be differentiated from other neurological conditions such as dystonia, chorea, athetosis, hamiballismus, seizures, myoclonus, tremor, and functional tics. […] Primary TD is a clinical diagnosis, and electroencephalogram, neuroimaging, psychological evaluation, and lab tests are mainly used to diagnose comorbidities or exclude other disorders, including secondary causes of TD. […] Patients with TD usually do not need specific treatment if tics are not distressing. […] The management of TD has been addressed by various consensus guidelines, including European Clinical Guidelines for TS and TD, Canadian guidelines for the evidence-based treatment of TD, and the most recent American Academy of Neurology Practice Guideline Recommendations for Treatment of TS and Chronic TD.

• #23 Tic – Wikipedia

  https://en.wikipedia.org/wiki/Tic

  Dystonias, paroxysmal dyskinesias, chorea, other genetic conditions, and secondary causes of tics should be ruled out in the differential diagnosis. Conditions besides Tourette syndrome that may manifest tics or stereotyped movements include developmental disorders, autism spectrum disorders, and stereotypic movement disorder; Sydenham’s chorea; idiopathic dystonia; and genetic conditions such as Huntington’s disease, neuroacanthocytosis, pantothenate kinase-associated neurodegeneration, Duchenne muscular dystrophy, Wilson’s disease, and tuberous sclerosis. Other possibilities include chromosomal disorders such as Down syndrome, Klinefelter syndrome, XYY syndrome, and fragile X syndrome. Acquired causes of tics include drug-induced tics, head trauma, encephalitis, stroke, and carbon monoxide poisoning.

• #24 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  Differential diagnosis of TS from functional tic-like presentations can therefore be challenging, especially for the general public, and even the general medical practitioner or clinical psychologist, and often requires subspecialty expertise and experience. […] The growing number of people with sudden onset tic-like phenomena typically do not manifest the usual tic symptoms and patterns. […] Functional tic-like symptoms seen in recent years primarily occur in adolescents, and females appear to be at higher risk. […] Interestingly, there is preliminary evidence that in some patients, pre-existing tics and TS may be a predisposing factor for the development of rapid-onset functional tic-like behaviors. […] Not surprisingly, therefore, tic-like behaviors developing after social media consumption differ from tics in Tourette syndrome, strongly suggesting that these phenomena are categorically different conditions.

• #25 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  The list in Table 1 takes into account the varying quality of evidence listed above, and suggests features common to functional tic-like behaviors that may help to distinguish FND from TS when taken together in a comprehensive clinical evaluation. […] The optimal multidisciplinary treatment for FND has not been standardized; recent reviews include the following references. […] Most experts believe that with early diagnosis and intervention, the prognosis is good and full recovery is possible. […] The first priority in managing FND is education. […] While Comprehensive Behavioral Intervention for Tics (CBIT) was developed and validated for the treatment of tics in TS, and has not been extensively studied in functional tic-like behaviors, there have been some reports that a modified CBIT program can be helpful. […] In summary, treatment must be individualized.

• #26 Diagnosis and Management of Functional Tic-Like Phenomena

  https://www.mdpi.com/2077-0383/11/21/6470

  Differential diagnosis of TS from functional tic-like presentations can therefore be challenging, especially for the general public, and even the general medical practitioner or clinical psychologist, and often requires subspecialty expertise and experience. […] Importantly, any type of repetitive movement condition can be problematic, and deserves care, but making the correct diagnosis is critical both to avoid inappropriate interventions and to find the optimal treatment for the patient. […] The growing number of people with sudden onset tic-like phenomena typically do not manifest the usual tic symptoms and patterns. […] Functional tic-like symptoms seen in recent years primarily occur in adolescents, and females appear to be at higher risk. […] Interestingly, there is preliminary evidence that in some patients, pre-existing tics and TS may be a predisposing factor for the development of rapid-onset functional tic-like behaviors.

• #27 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  Interestingly, some children with tics experienced improvement in response to the decreased social exposures associated with remote school and work. […] However, over the past 3 years, tic specialists worldwide have observed an increase in young people presenting for evaluation of tics and Tourette syndrome (TS). […] Others, however, present with distinct characteristics that differ significantly from those of typical tic disorders. […] These tic-like behaviors manifest abruptly in adolescents without a prior history or family history of tics, and phenomenologically do not conform with typical clinical features associated with tics. […] Tic-like presentations due to FND and typical tics (as seen in TS) share some features, including suggestibility, distractibility, and worsening in times of stress.

• #28 Tics and Tourette Syndrome

  https://practicalneurology.com/articles/2017-sept/tics-and-tourette-syndrome

  Recognizing the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] There is no diagnostic test for TS and, therefore, recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] Recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis of Tourette syndrome. […] Several different scales are used to assess various aspects of TS. […] Pathogenesis of TS is still not well understood, but various clinical, genetic, physiological, and imaging studies suggest that TS represents a developmental genetic disorder resulting in abnormal function in the corticostriatal-thalamic-cortical circuit, which then leads to motor and behavioral disinhibition.

• #29 Tourette syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/symptoms-causes/syc-20350465

  Tics sudden, brief, intermittent movements or sounds are the hallmark sign of Tourette syndrome. […] Tics are classified as: […] Tics can also involve movement (motor tics) or sounds (vocal tics). […] Before the onset of motor or vocal tics, you’ll likely experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. […] Not all tics indicate Tourette syndrome. […] There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. […] The exact cause of Tourette syndrome isn’t known. […] Risk factors for Tourette syndrome include: […] People with Tourette syndrome often lead healthy, active lives. […] Conditions often associated with Tourette syndrome include:

• #30 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. […] The Tourette Association of America (TAA) convened an international, multidisciplinary working group to better understand this apparent presentation of functional neurological disorder (FND) and its relationship to TS. […] Tics are characterized by changing severity and semiology over time, which understandably can present diagnostic challenges for clinicians. […] Although there are no pathognomonic diagnostic signs or lab tests to confirm tics, much is known about the typical course and symptoms, and clinicians with expertise in tic disorders can recognize consistent patterns. […] Tics may improve with intense focus or concentration and worsen during times of personal or social excitement or stress.

• #31 Diagnosis and Management of Functional Tic-Like Phenomena

  https://www.mdpi.com/2077-0383/11/21/6470

  Not surprisingly, therefore, tic-like behaviors developing “after social media consumption differ from tics in Tourette’s syndrome, strongly suggesting that these phenomena are categorically different conditions. […] The optimal multidisciplinary treatment for FND has not been standardized; recent reviews include the following references. […] Most experts believe that with early diagnosis and intervention, the prognosis is good and full recovery is possible. […] It is important to explain that FND can be completely distinct from TS, although the outward features may be similar. […] While these functional tic-like symptoms, like other FND symptoms, are not intentional, there may be some unintentional reinforcement or secondary gain in some patients. […] The occurrence of functional tic-like behaviors often has an impact on school, personal, or professional life.

• #32 Diagnosis and Management of Functional Tic-Like Phenomena

  https://www.mdpi.com/2077-0383/11/21/6470

  The first priority in managing FND is education. […] The clinician should ask the patient about symptom phenomenology, onset, and progression. […] The patient should also be screened for co-occurring disorders, including depression, anxiety, and adjustment disorders. […] It is critical to identify and address those co-occurring conditions through behavioral therapy and/or medication.

• #33 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  Differential diagnosis of TS from functional tic-like presentations can therefore be challenging, especially for the general public, and even the general medical practitioner or clinical psychologist, and often requires subspecialty expertise and experience. […] The growing number of people with sudden onset tic-like phenomena typically do not manifest the usual tic symptoms and patterns. […] Functional tic-like symptoms seen in recent years primarily occur in adolescents, and females appear to be at higher risk. […] Interestingly, there is preliminary evidence that in some patients, pre-existing tics and TS may be a predisposing factor for the development of rapid-onset functional tic-like behaviors. […] Not surprisingly, therefore, tic-like behaviors developing after social media consumption differ from tics in Tourette syndrome, strongly suggesting that these phenomena are categorically different conditions.

• #34 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  People with persistent (chronic) tic disorder have motor or vocal tics (not both) for more than one year. Persistent tic disorder affects less than 1% of school-age children. […] People with Tourette syndrome have motor and vocal tics (both) for more than one year. This is the most severe type of tic disorder. […] Tic disorders are fairly common. Researchers estimate that 1 out of every 50 children has Tourette syndrome or another tic disorder. […] Your child’s healthcare provider will perform a physical exam and evaluate their symptoms. If possible, it’s helpful to bring along a video or two of your child performing their tics so their provider can see what exactly your child is experiencing. […] Based on what type of tics and their duration, your child’s provider may make a diagnosis of a certain type of tic disorder. Your child’s provider may also evaluate them for other disorders that often accompany tics, like ADHD and OCD.

• #35 Tourettes Syndrome and Tic Disorders: Symptom Diagnosis & TreatmentFooterLogo

  https://www.additudemag.com/tic-disorders-and-tourette-syndrome/?srsltid=AfmBOooGtLselOowGt5vmx9dP4GFhFrjCuLUBT5ZCp-BTvLyvVQbk1fY

  Sudden jerking movements or seemingly involuntary sounds may be signs of a tic disorder like Tourette’s Syndrome. Here’s what you need to know about sorting out symptoms, getting a diagnosis, and pursuing treatment for tics. […] A person with a tic disorder experiences sudden twitches of whole muscle groups, most often in the eyes, mouth, shoulders, or neck. […] There are several types of tic disorders: transient tic disorder, chronic tic disorder, Tourette Syndrome, and tic disorder NOS. […] Tic disorders — including Tourette Syndrome, the most well-known of the group — rarely travel alone. They’re most commonly seen with ADHD, obsessive-compulsive disorder, and mood disorders. In fact, studies suggest that up to 60 percent of children with Tourette Syndrome also have ADHD. […] There’s currently no brain scan or other neurological test designed to diagnose tic disorders — meaning your doctor will rely mainly on a clinical interview and observation to diagnose a tic disorder in you or your child.

• #36 Tourettes Syndrome and Tic Disorders: Symptom Diagnosis & TreatmentFooterLogo

  https://www.additudemag.com/tic-disorders-and-tourette-syndrome/?srsltid=AfmBOooGtLselOowGt5vmx9dP4GFhFrjCuLUBT5ZCp-BTvLyvVQbk1fY

  A thorough evaluation will also assess for co-existing conditions — particularly autism, ADHD, mood disorders, or OCD. Overlapping or lookalike symptoms are often present, potentially complicating the diagnosis and subsequent treatment plan. […] Since the majority of tics stop on their own without treatment, many experts recommend a “wait and see” approach for tic disorders in children, especially if they cause the individual minimal embarrassment. If the tics persist — or cause great distress — stress-reduction techniques, habit-reversal therapy, and behavioral therapy have been shown to work wonders, for both children and adults with tic disorders. If no other options prove effective, some medications can be used to help suppress tics. […] About 60% of children with Tourette Syndrome have ADHD.

• #37 Tourette’s Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p651.html

  Tourette’s syndrome is a movement disorder most commonly seen in school-age children. […] Given its diverse presentation, Tourette’s syndrome can mimic many hyperkinetic disorders, making the diagnosis challenging at times. […] Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected children. […] Diagnostic criteria for Tourette’s syndrome highlight the presence of multiple tic types, the total duration of symptoms, and age at onset before 18 years. […] Males are five times more likely to be affected, and the prevalence may approach 0.72 percent. […] Complete resolution occurs by age 18 in 50 percent of patients with Tourette’s syndrome. […] Tics and comorbidities improve with the use of selective serotonin reuptake inhibitors (SSRIs) and dopamine-receptorblocking drugs, thereby implicating dopaminergic and serotonergic neurotransmission in Tourette’s syndrome pathophysiology.

• #38 Tourette’s Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0301/p651.html

  The goal of treatment should be to improve social functioning, self-esteem, and quality of life. […] Treatment should be individually tailored, and a combination of drugs may be required. […] Dopamine-receptorblocking drugs remain the most effective pharmacologic treatment for tics. […] Haloperidol and pimozide are FDA-approved for this indication. […] Medically refractory motor and phonic tics may require referral to specialty centers. […] Comorbid ADHD, OCD, and other mood disorders should be treated when necessary.

• #39 Tic Disorders (Tics) and Tourette’s – PsychDB

  https://www.psychdb.com/child/motor/tic-disorders

  Tics are sudden, rapid, recurrent, non-rhythmic motor movements or vocalizations. […] Tourettes Disorder is the most famous of the tic disorders. […] Tic severity peaks by age 11, and there is a gradual decrease in symptoms afterwards for most (around 80%). […] The treatment of comorbid conditions in tic disorder is important. […] Tic disorders can be classified in to 4 disorders: Tourettes disorder, Persistent (chronic) motor or vocal tic disorder, Provisional tic disorder, Other specified and unspecified tic disorders. […] Tic disorders are hierarchical in order – once a tic disorder at one level of the hierarchy is diagnosed, a lower hierarchy diagnosis cannot be made (Criterion E). […] Both multiple motor and 1 or more vocal tics have been present at sometime during the illness, although not necessarily concurrently.

• #40 Recognition and Management of Tourette’s Syndrome and Tic Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0415/p2263.html

  Primary care physicians are often the first physicians to be consulted about tics. Tics are defined as sudden, rapid, purposeless, repetitive, nonrhythmic, stereotyped movements or vocalizations. Tics are either transient, with a duration of less than 12 consecutive months, or chronic, with a course that lasts more than a year, and can be either primary (idiopathic) or secondary. […] Tourette’s syndrome is a chronic tic disorder that is characterized by both motor and vocal tics, with onset in childhood. This disorder usually begins with simple tics and progresses to more complex tics. […] The single most important component of management is an accurate diagnosis. Tics should be differentiated from other movement disorders such as chorea, stereotypy and dystonias. […] The second step in management is to rule out the secondary causes of tic disorders. The degree of inclusiveness of the work-up for Tourette’s syndrome depends on the patient’s history, the family history and specific patient characteristics.

• #41 Recognition and Management of Tourette’s Syndrome and Tic Disorders | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/0415/p2263.html

  An electroencephalogram is likely to be nonspecifically abnormal and is useful only in patients in whom it is difficult to differentiate tics from manifestations of epilepsy. […] The following steps should be included in the preliminary management of tic disorders: (1) a detailed history—age of onset, family history, other medical concerns, evidence of waxing and waning course; (2) descriptions of reported and observed behaviors; and (3) specific follow-up observations or referral questions. […] The therapeutic goal should not be to decrease tics to a level at which they are no longer noticeable. The goal in tic control is to use the lowest dosage of medication that will enhance the patient’s functioning to an acceptable level.

• #42 Understanding Tic Disorders: A Round Table on Diagnosis, Treatment, and Research – ACAMH

  https://www.acamh.org/freeview/understanding-tic-disorders-a-round-table/

  And it makes you think that yes, there must be lots of people out there with say, simple eye blinking tics or throat clearing tics, and they’ve lived their whole life without a diagnosis. […] Not every tic needs to be described. But I guess if clinical healthcare professionals are seeing tics as part of something else, even just the acknowledgement of, you know, Oh, I see that you have a movement, or You’re making a sound, etc., that might even be the first time that they have had that acknowledged by somebody and that, in itself, might be helpful. […] So, we’re doing some research to try and map what the current provision is and also, to try and address this within the INTEND project. […] The reason why that’s important, I know I’m sure there’ll be patients, perhaps, that are listening to this, saying, I could tell you this. I absolutely know this. But we need to be able to evidence this so that we can have these conversations with Commissioners, with people like NICE, big decision-makers, say, This is where we are letting people down.

• #43 Is it actually Tourette’s? – The over use of a diagnosis.

  https://www.tictocktherapy.co.uk/post/is-it-actually-tourette-s-the-over-use-of-a-diagnosis

  If you or your child have had a sudden onset of tics, with no previous history of tics, no family link to tics, and only been ticcing for a handful of weeks or months, you DO NOT fit the criteria of Tourette’s syndrome. […] If you do not fit the diagnostic criteria, challenge them! You have a right to request to be referred to a neurologist or tic specialist, you have the right for a second opinion, you have the right to challenge this. […] PANDAS is a clinical diagnosis based on 5 distinct criteria as developed by the NIMH and listed below. Currently there are no definitive diagnostic laboratory tests for PANDAS, but the Cunningham Panel is the first and only test that was developed specifically as an aid to doctors in making their diagnosis. […] I’m writing this article to empower you to be brave enough to challenge medical professionals who are dishing out Tourette’s diagnoses like they are earning commission. […] It IS important to have the correct diagnosis, to be able to access the correct support and intervention so please don’t be afraid to do so.

• #44 Tic Disorders and Tourette Syndrome Program | Boston Children’s Hospital

  https://www.childrenshospital.org/programs/tic-disorders-and-tourette-syndrome-program

  At Boston Childrens, our Tic Disorders and Tourette Syndrome Program takes a multidisciplinary approach to treating and caring for children with tic disorders and Tourette syndrome. Our goal is to provide each patient with a thorough evaluation so we can give a correct diagnosis and the best possible treatment available. […] The Tic Disorders and Tourette Syndrome Program focuses on helping children thrive and improve their tics, providing resources to support them and their families. Program director Kinga Tomczak, MD, PhD, a child neurologist and tic disorder specialist, along with the programs team of nurse practitioners, regularly recommend a comprehensive treatment plan, which can include Comprehensive Behavioral Intervention for Tics (CBIT) therapy, medications, and lifestyle modifications. Your childs care team will provide different medication choices based on their specific needs and other health conditions. We discuss possible side effects and suggest medications that can help with not just tic symptoms, but also concerns such as ADHD, headaches, sleep problems, or anxiety.

• #45 Getting diagnosed with TS

  https://www.tourettes-action.org.uk/20-getting-diagnosed.html

  A diagnosis of Tourette syndrome (TS) can lead to greater understanding of the condition, access to healthcare, support networks and services. […] For TS to be diagnosed, multiple motor tics and at least one vocal tic must be present for at least 12 months. […] TS can only be diagnosed by observing and evaluating symptoms and there are rating scales to help with the assessment of tic severity. […] Health professionals who can diagnose TS are: Neurologists, Psychiatrists and Paediatricians. […] To pursue a diagnosis of TS there are some simple steps to follow: […] During the appointment the specialist will talk to you about the symptoms and will observe any tics during the meeting. They will make a clinical diagnosis based on their observations and if they diagnose TS they may suggest relevant treatment.

• #46 About Tourette Syndrome | Tourette Syndrome | CDC

  https://www.cdc.gov/tourette-syndrome/about/index.html

  Health professionals look at the person’s symptoms to diagnose TS and other tic disorders. […] There is no single test, like a blood test, to diagnose TS. Health professionals look at the person’s symptoms to diagnose TS and other tic disorders. The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or combination of the both), and how long the symptoms have lasted. TS can be diagnosed if a person has both motor and vocal tics, and has had tic symptoms for at least a year. […] Depending on the type of tics a person has, and how long the tics last, a person might be diagnosed with Tourette syndrome or another type of tic disorder.

• #47 Tourette Syndrome (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/tourette.html

  To be diagnosed with Tourette syndrome, a child must have several different types of tics specifically, multiple motor tics and at least one vocal tic for at least a year. They may happen every day or from time to time throughout the year. […] There isn’t a specific diagnostic test for Tourette syndrome. Instead, the health care provider diagnoses it after taking a family history, medical history, looking at the symptoms, and doing an exam. Sometimes, imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests can rule out other conditions that might cause symptoms similar to Tourette syndrome.

• #48 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  People with persistent (chronic) tic disorder have motor or vocal tics (not both) for more than one year. Persistent tic disorder affects less than 1% of school-age children. […] People with Tourette syndrome have motor and vocal tics (both) for more than one year. This is the most severe type of tic disorder. […] Tic disorders are fairly common. Researchers estimate that 1 out of every 50 children has Tourette syndrome or another tic disorder. […] Your child’s healthcare provider will perform a physical exam and evaluate their symptoms. If possible, it’s helpful to bring along a video or two of your child performing their tics so their provider can see what exactly your child is experiencing. […] Based on what type of tics and their duration, your child’s provider may make a diagnosis of a certain type of tic disorder. Your child’s provider may also evaluate them for other disorders that often accompany tics, like ADHD and OCD.

• #49 Tourette Syndrome in Children | Pediatric Neurologists Austin & Cedar Park

  https://www.childneurotx.com/conditions/tics-tourette-syndrome/

  Tourette Syndrome (TS) is a neurological disorder characterized by multiple repeated tics. Tics are abrupt, purposeless, and involuntary movements or vocal sounds. Some are mild and barely noticeable, while others can be severe and disruptive. […] The diagnosis of Tics and TS is based on the child’s history and a thorough physical examination by a specialist. Criteria used to diagnose Tourette syndrome include: […] Both motor tics and vocal tics are present, although not necessarily at the same time. […] Tics occur several times a day, nearly every day or intermittently, for more than a year. […] Tics begin before age 18. […] Tics aren’t caused by medications, other substances, or another medical condition.

• #50 Tourette syndrome: Much more than tics, part 1: Diagnosis

  https://www.contemporarypediatrics.com/view/tourette-syndrome-much-more-tics-part-1-diagnosis-0

  Far more people have heard of Tourette syndrome than know what it actually looks and sounds like – or how it feels to the person who has it. That’s a major reason the diagnosis of this condition – the most severe tic disorder – is often missed. […] The diagnosis of TS (the focus of Part 1 of this two-part article) and its management (the focus of Part 2) depend on recognizing the unique clinical presentation of each child and directing an ongoing comprehensive and supportive care plan. […] TS is the most severe tic disorder, marked by both motor and phonic tics. […] The tics of TS range widely in their severity, form, frequency, and intensity. Moreover, although tics are the hallmark of diagnosis, TS is associated with a range of comorbid conditions. When present, these conditions are usually more serious or disabling than the tics themselves.

• #51 Tourette syndrome: Much more than tics, part 1: Diagnosis

  https://www.contemporarypediatrics.com/view/tourette-syndrome-much-more-tics-part-1-diagnosis-0

  Tics typically appear in early childhood (most often by 6 or 7 years), initially as simple motor tics, followed by phonic tics and more complex motor tics usually within the ensuing two years or so, although sometimes not until early or middle adolescence. […] A single tic may bring relief for some people (or, for a particular person, some of the time), whereas for other people (or at other times) a rapid succession of repeated tics or orchestrations of tics is required. […] The ability to suppress tics distinguishes the movements from other hyperkinetic movement disorders and is a useful diagnostic aid. […] Although the diagnostic criteria for TS are straightforward, the diagnosis is often missed. Misconceptions about the syndrome explain much of this oversight.

• #52 Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Tourette_syndrome

  Tourette syndrome or Tourette’s syndrome (abbreviated as TS or Tourette’s) is a common neurodevelopmental disorder that begins in childhood or adolescence. […] There are no specific tests for diagnosing Tourette’s; it is not always correctly identified, because most cases are mild, and the severity of tics decreases for most children as they pass through adolescence. […] According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Tourette’s may be diagnosed when a person exhibits both multiple motor tics and one or more vocal tics over a period of one year. […] The diagnosis is usually made based on observation of the individual’s symptoms and family history, and after ruling out secondary causes of tic disorders (tourettism). […] Delayed diagnosis often occurs because professionals mistakenly believe that TS is rare, always involves coprolalia, or must be severely impairing.

• #53 Tourette syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Tourette_syndrome

  The DSM has recognized since 2000 that many individuals with Tourette’s do not have significant impairment; diagnosis does not require the presence of coprolalia or a comorbid condition, such as ADHD or OCD. […] Tics that appear early in the course of TS are often confused with allergies, asthma, vision problems, and other conditions. […] Tics that may appear to mimic those of Tourette’s—but are associated with disorders other than Tourette’s—are known as tourettism and are ruled out in the differential diagnosis for Tourette syndrome. […] The typical age of onset of TS is before adolescence.

• #54 Tics and Tourette Syndrome

  https://practicalneurology.com/articles/2017-sept/tics-and-tourette-syndrome

  Recognizing the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] There is no diagnostic test for TS and, therefore, recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] Recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis of Tourette syndrome. […] Several different scales are used to assess various aspects of TS. […] Pathogenesis of TS is still not well understood, but various clinical, genetic, physiological, and imaging studies suggest that TS represents a developmental genetic disorder resulting in abnormal function in the corticostriatal-thalamic-cortical circuit, which then leads to motor and behavioral disinhibition.

• #55 Tic Disorders and Tourette Syndrome in Children and Adolescents – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/neurologic-disorders-in-children/tic-disorders-and-tourette-syndrome-in-children-and-adolescents

  Tics are defined as repeated, sudden, rapid, nonrhythmic muscle movements including sounds or vocalizations. Tourette syndrome is diagnosed when people have had both motor and vocal tics for 1 year. Diagnosis is clinical. […] Diagnosis is clinical. To differentiate Tourette syndrome from transient tics, physicians may have to monitor patients over time. Tourette syndrome is diagnosed when people have had both motor and vocal tics for 1 year. […] Strongly consider Comprehensive Behavioral Intervention for Tics (CBIT) as the initial treatment option for tics. An alpha-adrenergic agonist such as clonidine or guanfacine is beneficial for both mild tics and ADHD. An antipsychotic may lessen severe or difficult to control tics but may cause adverse effects. Comorbidities (eg, ADHD, obsessive-compulsive disorder) are common and must also be diagnosed and treated.

• #56 Chronic tic disorders: diagnosis, treatment and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/chronic-tic-disorders-diagnosis-treatment-and-management

  Chronic tic disorders: diagnosis, treatment and management. How different types of tic disorders are diagnosed and the appropriate therapeutic options for their management, with a focus on Tourette syndrome. Tic disorders are hyperkinetic movement disorders characterised by the presence of tics (involuntary, sudden, rapid, recurrent, non-rhythmic movements or vocalisations). This article reviews current knowledge about the diagnosis and management of different types of tic disorders, with a focus on Tourette syndrome. The current edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) classifies tic disorders as movement disorders within the ‘Neurodevelopmental disorders’ section. Specifically, the DSM-5 lists four criteria for Tourette syndrome (DSM-5 code 307.23): 1. The presence of both motor and vocal/phonic tics at some time during the illness (not necessarily concurrently); 2. The persistence of tics for more than one year since first tic onset, irrespective of the duration of tic-free periods; 3. The onset age before 18 years; 4. The absence of underlying organic causes for the tics. The diagnosis of Tourette syndrome requires expert observation and in-depth history-taking to document the chronic presence of multiple motor and vocal/phonic tics since childhood. The high prevalence of co-morbid obsessive compulsive features and attention deficit and hyperactivity symptoms can pose considerable diagnostic challenges, even to experienced clinicians.

• #57 Reddit – The heart of the internet

  https://www.reddit.com/r/Tourettes/comments/18q72o5/do_not_selfdiagnose_tics/

  Tics are a symptom of a neurological origin, not a diagnosis in itself. […] If you are experiencing involuntary movement, you need to see a NEUROLOGIST. […] It could be types of epilepsy, myoclonus, brain inflammation like BGE/PANS/PANDAS, side-effects from antipsychotic medications, and other movement disorders that you cannot diagnose yourself and even your regular doctor is not trained enough to diagnose alone. […] Don’t ask reddit if you have tics or Tourettes; GO SEE A NEUROLOGIST. 20 year old redditors are not equipped to diagnose you with a tic disorder or Tourette’s Syndrome over the internet.

• #58 Getting diagnosed with TS

  https://www.tourettes-action.org.uk/20-getting-diagnosed.html

  A diagnosis of Tourette syndrome (TS) can lead to greater understanding of the condition, access to healthcare, support networks and services. […] For TS to be diagnosed, multiple motor tics and at least one vocal tic must be present for at least 12 months. […] TS can only be diagnosed by observing and evaluating symptoms and there are rating scales to help with the assessment of tic severity. […] Health professionals who can diagnose TS are: Neurologists, Psychiatrists and Paediatricians. […] To pursue a diagnosis of TS there are some simple steps to follow: […] During the appointment the specialist will talk to you about the symptoms and will observe any tics during the meeting. They will make a clinical diagnosis based on their observations and if they diagnose TS they may suggest relevant treatment.

• #59 Getting diagnosed with TS

  https://www.tourettes-action.org.uk/20-getting-diagnosed.html

  Based on your needs your consultant may arrange another appointment to see you again, or it may be felt that treatment can continue through your GP and other local services. […] Your GP may refer your child to Child and Adolescent Mental Health Services (CAMHS) for treatment of TS. […] If a young person is presenting with behavioural problems or other TS like symptoms, they may be referred onto CAMHS by their GP or another third party such as school or social services. […] „Having a diagnosis has meant that I can access the help and support I need to be independent and happy.”

• #60 Tourette Syndrome: What Is It, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5554-tourette-syndrome

  The tics associated with Tourettes are involuntary, so they aren’t something you can control. […] Tourette syndrome isn’t preventable. But, early detection and treatment may prevent TS from worsening or lasting into adulthood. […] There’s no cure for Tourette syndrome. The condition usually improves in early adulthood. Tics may still occur, but most adults don’t need to continue medication or therapy. […] Tourette syndrome is a neurological condition. It causes someone to make involuntary movements or sounds called tics. The disorder starts in childhood and usually decreases in early adulthood. Medication and behavioral therapy are the most common treatments for Tourette syndrome.

• #61 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  Tic disorder treatment depends on the type and severity of your child’s condition. If their condition is mild, they may not need any treatment, and their tics may resolve on their own. […] In other cases, if your child’s tics are severe and interfering with their daily life, their healthcare provider may recommend behavioral therapy, medication or both. […] If the tics persist and are interfering with your child’s life, medications for tics may help. […] Tics usually improve on their own over time and may stop completely. Sometimes, a tic may last for just a few months, but more frequently, they come and go over several years. […] Some tics aren’t serious. You don’t need to see your child’s provider if their tics are mild and not causing any problems. The tics may even disappear as quickly as they appeared. But you should schedule an appointment with your child’s provider if you’re concerned about their tics or the tics:

• #62 Tics and Tic Disorders: What They Are, Causes & Types

  https://my.clevelandclinic.org/health/diseases/tics-and-tic-disorders

  If your child has developed a tic, you may be worried, stressed or concerned. But while the presence of tics can be alarming, they’re usually not serious. In fact, many mild cases of tics go away on their own. But if your child’s tics have become more frequent or severe, it may be time to reach out to their healthcare provider.

• #63 Tics

  https://www.rch.org.au/kidsinfo/fact_sheets/Tics/

  Most people with tics do not require any specific treatment. This is particularly the case when tics are not interfering with the young person’s daily life. […] Where tics are disruptive, psychological treatments and medicines can be considered. […] Medications can reduce severity and frequency of tics but cannot stop or cure the tics. […] You should visit your GP or paediatrician if you are worried about your child’s movements or their learning, concentration or development. […] Tics are movements and sounds that people make involuntarily. […] Tics are not harmful to your child, but some children with tics experience difficulty concentrating, fidgeting, impulsivity or anxiety. […] Home videos can be helpful for diagnosis. […] Speak to your GP if you are worried about your child’s tics.

• #64 Fractal tics may pave way to faster diagnosis | BPS

  https://www.bps.org.uk/research-digest/fractal-tics-may-pave-way-faster-diagnosis

  Recent research finds repeating patterns in Tourettes tics, opening up potential for much faster diagnoses in future. […] To receive a diagnosis of Tourette syndrome, a child must have had movement and sound tics for at least a year. […] a new paper in the Journal of the Royal Society Interface describes a method that could potentially cut that year-long diagnosis time down to just a day. […] the timing of tics of someone with Tourette’s show a fractal pattern an infinite pattern that is self-similar across different scales. […] the degree to which tics follow fractal patterns can predict how severe their condition will become. […] These findings suggest that a fractal dimension value might serve as an objective measure of tic severity. […] the researchers also hope that it might be possible to use this approach to diagnose Tourette syndrome immediately, during a child’s initial evaluation, rather than after a 12-month wait. […] If this approach could be used to diagnose Tourette syndrome immediately, this would clearly help patients, who could start receiving treatment immediately.

• #65 Tourette’s Syndrome and Tics Treatment & Diagnosis | Pacific Movement Disorders

  https://www.pacificneuroscienceinstitute.org/movement-disorders/conditions/tics-tourettes-syndrome/

  Tourettes syndrome is a clinical diagnosis, meaning that it is based on the symptoms and signs on examination. […] Various rating scales can be employed to quantify the severity of the condition, including the Yale Global Tic Severity Scale, which assesses the frequency, complexity and number of tics, as well as the degree to which they interfere with daily life. […] There are no blood tests for Tourettes, nor MRI findings, but research is being done on genetic etiologies of Tourettes syndrome since a family history is common and there is often overlap with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD).

• #66 Tourette Syndrome: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/neuro/parkinsons-disease-movement-disorders/tourette-syndrome

  Tic severity often peaks between 10-12 years old and can decline in adolescence. […] The three types of tic disorders diagnoses are: […] People diagnosed with Tourette syndrome have had tic symptoms for at least one year. […] Those with persistent tic disorder have had tic symptoms for more than one year. […] Individuals with provisional tic disorder have had symptoms for less than one year. […] Motor and vocal tics are the main symptoms of Tourette syndrome. […] Tics can happen randomly or may be associated with: […] The exact cause of Tourette syndrome is unknown, though genetic mutations (changes) and environmental factors might play a role. […] The experts at NewYork-Presbyterian are conducting clinical research on neurological conditions, including Tourette syndrome and other tic disorders, to find better ways to diagnose and treat them.

• #67 Understanding Tic Disorders: A Round Table on Diagnosis, Treatment, and Research – ACAMH

  https://www.acamh.org/freeview/understanding-tic-disorders-a-round-table/

  So, we’ve already conducted a research trial, where we’ve looked at ORBIT, we compared it to what we call a control, something to check whether it actually made a difference or not, and we found that ERP, when delivered online, was really effective in helping young people to control their tics. […] So, we’ve got some great research going on. […] The purpose of INTEND is to look at the current provision of tic services. […] We know there’s great centres, for example, those led by Tammy and also Joe, and other experts, but where are they based? […] The call is now open for adults. […] We know that they know that there needs to be a better offer for evidence-based therapy for young people, and their call that they’ve put out is specifically to look at the use of digital therapy and how that can be used to support people with tic disorders, both young people and adults, as well.

• #68 Diagnosis and Management of Functional Tic-Like Phenomena

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9656241/

  The list in Table 1 takes into account the varying quality of evidence listed above, and suggests features common to functional tic-like behaviors that may help to distinguish FND from TS when taken together in a comprehensive clinical evaluation. […] The optimal multidisciplinary treatment for FND has not been standardized; recent reviews include the following references. […] Most experts believe that with early diagnosis and intervention, the prognosis is good and full recovery is possible. […] The first priority in managing FND is education. […] While Comprehensive Behavioral Intervention for Tics (CBIT) was developed and validated for the treatment of tics in TS, and has not been extensively studied in functional tic-like behaviors, there have been some reports that a modified CBIT program can be helpful. […] In summary, treatment must be individualized.

• #69 Tics and Tourette syndrome 101 | Texas Children’s

  https://www.texaschildrens.org/content/wellness/tics-and-tourette-syndrome-101

  Tourette syndrome is a neurological condition in which affected persons demonstrate brief, repetitive movements and vocalizations called tics. […] A formal diagnosis of Tourette syndrome is met when at least one year has passed since the onset of the first tic, and the patient has experienced at least one phonic tic and at least two motor tics. […] A pediatrician, neurologist or child psychiatrist will usually diagnose tics in children and adolescents. Movement disorder specialists are neurologists who have additional training in the diagnosis and treatment of involuntary movements, including tics. […] When diagnosing Tourette syndrome or other tic disorders, tics need to be distinguished from other abnormal movements (e.g., stereotypy, chorea) or compulsive behaviors. Evaluation must include a full neurologic examination. Understanding the nature, severity and functional consequences of tics is integral to the development of an effective treatment plan. […] Tics only need to be treated when they are bothering the person who has them. Not everyone needs to take medications for tics. While medication is the mainstay of tic treatment, some patients are good candidates for other interventions, including a form of behavioral therapy called CBIT.

• #70

  https://journals.lww.com/annalsofian/fulltext/2023/26060/an_update_on_the_diagnosis_and_management_of_tic.6.aspx

  Tic disorders (TDs) are a group of common neuropsychiatric disorders of childhood and adolescence. TD is a clinical diagnosis based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. TDs are more prevalent in children than in adults and in males than in females. The prevalence of TS was 0.77%, four times higher in boys as compared to girls. A patients susceptibility to develop TD may result from a complex interaction between various genetic, environmental, and immunological factors. Dysregulation in the cortico-striato-pallido-thalamo-cortical (CSPTC) network is the most plausible pathophysiology resulting in TD. TD is a clinical diagnosis. It is based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. The presence of motor and/or vocal tics, duration of illness, age at tic onset, and absence of secondary causes are important to diagnose different types of TD as per DSM-V criteria. Primary TD is a clinical diagnosis, and electroencephalogram, neuroimaging, psychological evaluation, and lab tests are mainly used to diagnose comorbidities or exclude other disorders, including secondary causes of TD. Patients with TD usually do not need specific treatment if tics are not distressing.

• #71 An Update on the Diagnosis and Management of Tic Disorders

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10789408/

  Tic disorders (TDs) are a group of common neuropsychiatric disorders of childhood and adolescence. […] TD is a clinical diagnosis based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. […] TDs are more prevalent in children than in adults and in males than in females. […] The prevalence of TS was 0.77%, four times higher in boys as compared to girls. […] A patient’s susceptibility to develop TD may result from a complex interaction between various genetic, environmental, and immunological factors. […] Dysregulation in the cortico-striato-pallido-thalamo-cortical network is the most plausible pathophysiology resulting in TD. […] TD is a clinical diagnosis. It is based on clinical features and findings on neurological examination, especially the identification of tic phenomenology.

• #72 Tics and Tourette Syndrome

  https://practicalneurology.com/articles/2017-sept/tics-and-tourette-syndrome

  Recognizing the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] There is no diagnostic test for TS and, therefore, recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis. […] Recognition of the full spectrum of phenomenology of tics and various behavioral comorbidities is critical to diagnosis of Tourette syndrome. […] Several different scales are used to assess various aspects of TS. […] Pathogenesis of TS is still not well understood, but various clinical, genetic, physiological, and imaging studies suggest that TS represents a developmental genetic disorder resulting in abnormal function in the corticostriatal-thalamic-cortical circuit, which then leads to motor and behavioral disinhibition.

• #73 Tics or Tourette Syndrome and Medications

  https://www.cincinnatichildrens.org/health/t/tics-ts-meds

  Tourette Syndrome is diagnosed in children who have a series of different repetitive, patterned movements called motor tics, and sounds called vocal tics, for more than a year. […] There is no medical test available for Tourette Syndrome or tic disorders. If the neurological symptom is tics, and the neurological and medical examination is otherwise normal, it is not necessary to order any tests. […] Tics should be treated if they are painful or disruptive to the child’s life. […] Tics can improve without medication. […] Tics should not be treated just because they are noticed. Tics are not harmful, and for many children, no medication treatment is needed. […] Treatment with medication may be helpful when tics are associated with pain, social/psychological problems, functional interference, or classroom disruption. […] A behavioral treatment called Comprehensive Behavioral Intervention for Tics has been shown in carefully conducted research to be helpful for managing symptoms of Tourette Syndrome.

• #74 Tics & Tourette Syndrome

  https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Tics–Tourette-Syndrome.htm

  Tics are brief movements or sounds that resemble voluntary actions, but appear suddenly, without regularity, often exaggerated in intensity and are repetitive and inopportune to social context. […] Tics can be encountered in a wide range of neurodevelopmental, neurometabolic and neurodegenerative disorders. However, in the clinical setting are most commonly seen in Gilles de la Tourette syndrome (or just Tourette syndrome: TS). According to DSM-5, TS is defined by the presence of at least two motor tic behaviors and one vocal tic behavior for a minimum period of a year, manifesting before the age of 18. […] As with any disorder, but more so with tics, treatment already begins at the time of diagnosis. This means that in the majority of cases explaining the neurobiological background of the disorder and the spectrum of associated phenomena and comorbidities might suffice.

• #75 Tics & Tourette Syndrome

  https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Tics–Tourette-Syndrome.htm

  However, when tics are harmful or socially disturbing, therapeutic venues, including behavioral and pharmacological are necessary. […] Atypical (e.g. aripiprazole, risperidone, olanzapine, ziprasidone) and first-line antipsychotics (e.g. haloperidol, pimozide, fluphenazine) have both been evaluated for the treatment of tics. […] Botulinum toxin may also often be helpful, specifically in cases with somatotopically restricted and particularly bothersome tics, most commonly involving the face or neck and shoulders. […] Indeed, tics and their treatment often fall sort due to the relatively benign nature of the movement disorder and the challenging range of associated neuropsychiatric comorbidities. However, tics and their associations are often manageable in a very satisfactory way, particularly in centers where movement disorders expertise is conjoined with knowledge and skills from the neighboring fields of neuropsychiatry, psychology and pediatrics.

• #76 What Are Tics and Tourette’s? – Child Mind Institute

  https://childmind.org/article/tics-and-tourettes/

  Tics are repeated, rapid movements or sounds. When a child develops a tic it can be scary for parents. The good news is that most tics go away on their own. But tics that don’t, or that start having an impact on your child’s daily life, may need treatment. […] If you think your child has developed a tic, start by visiting your pediatrician. […] If tics are mild and last less than a year, kids may be diagnosed with “provisional tic disorder.” Kids with provisional tic disorder often stop ticcing on their own and don’t need treatment. If tics have gone on for longer than a year, kids may have a chronic motor or vocal tic disorder. These disorders usually need treatment to get better. Kids with Tourette’s syndrome have more than one motor tic and at least one vocal tic, and they require treatment.

• #77 What Are Tics and Tourette’s? – Child Mind Institute

  https://childmind.org/article/tics-and-tourettes/

  The best treatment for tic disorders is called habit reversal therapy (HRT). During HRT kids learn to recognize the feeling that happens right before a tic. Then they develop a “competing” response — something to do instead of the tic. […] Parents who are concerned that a child may have a tic disorder should begin by visiting their pediatrician. The pediatrician can then determine if more help is needed and offer a referral to a neurologist or a psychiatrist. […] That said, Dr. Nash recommends parents seek treatment if: Tics have been present for over a year, or are becoming more severe; Tics are causing social problems or have become upsetting to your child. […] The treatment of choice for tic disorders is a form of cognitive behavioral therapy called habit reversal therapy (HRT). The goal of HRT is to help kids develop a kind of early warning defense system to help them counteract the tics before they occur. […] Habit reversal therapy is often effective on its own but in some cases your child’s doctor may suggest combining it with medication.

• #78 Understanding Tic Disorders: A Round Table on Diagnosis, Treatment, and Research – ACAMH

  https://www.acamh.org/freeview/understanding-tic-disorders-a-round-table/

  Highlighting the impact of the lack of NICE guidelines on equity of services, the speakers will also share the importance and need for NICE guidelines on Tic Disorders to improve diagnosis, treatment, and management. […] I think the general awareness of neurodiversity has improved over the last decade, particularly, and in the last five years with that. […] I think one of the things that most people don’t know about, as you talked about in your introduction, Seonaid, is that tics are not rare, but most tics are very mild. […] And I think the other aspect of that is that I think people naturally, with tics, are quite self-conscious, don’t want to bring attention to themselves, so don’t, naturally, talk about it as openly and as easily as they might if they have conditions such as ADHD, where, say, impulsivity is a bit more of a factor.

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