Tourette Syndrome

Tourette syndrome is characterized by motor or vocal tics, and was first described by Gilles de la Tourette in 1885. It is estimated that 1 in 1,000 to 1 in 100 persons have the syndrome, which occurs in males four times as often as in females. Tourette syndrome may be passed down through families, although currently no genetic marker has been found.

Tic severity varies from patient to patient, usually appearing at age 7 to 10, and often peaking by the early teens. In about one-third of patients, symptoms continue into adulthood.

In a small number of patients, tics become disabling, especially when they include self-injurious motions or utterances that prohibit social integration.  Many such patients also suffer from comorbidities such as obsessive-compulsive disorder, depression, and anxiety.

Symptoms of Tourette syndrome are usually not treated unless they are disabling. Therapy options include behavior therapy and/or medications.

While a neurologist’s choice of medications to try for a patient’s Tourette syndrome will vary by case, options that have been reported include anti-seizure medications, antidepressants, anti-anxiety medications, and dopamine blockers. (1)

For adults whose Tourette’s symptoms are severe and have not responded to other treatments, deep brain stimulation (DBS) has been investigated. Several DBS targets have been investigated in studies involving a small number of patients, such as the globus pallidus internus, centromedial-parafascicular complex of the thalamus, and the anterior limb of the internal capsule near nucleus accumbens. (1, 2)

References:

1. A.D.A.M. Medical Encyclopedia. U.S. National Library of Medicine.  Gilles De La Tourette Syndrome. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001744/. Accessed Jan. 29, 2013.

2. Mink, J. W., Walkup, J., Frey, K. A., Como, P., Cath, D., DeLong, M. R., Erenberg, G., Jankovic, J., Juncos, J., Leckman, J. F., Swerdlow, N., Visser-Vandewalle, V. and Vitek, J. L. (2006), Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome. Mov. Disord., 21: 1831–1838.

Reviewed Feb. 14, 2013
Hong Yu, MD
Member, International Neuromodulation Society
Clinical Assistant Professor, Department of Neurosurgery, Stanford University, Stanford, California, USA

• Definition list
• Therapies page
• Table summarizing research studies of deep brain stimulation in Tourette Syndrome