Clinical Review

Tourette’s syndrome

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4964 (Published 20 August 2013) Cite this as: BMJ 2013;347:f4964
  1. Andrea E Cavanna, consultant in behavioural neurology and honorary professor in neuropsychiatry123,
  2. Stefano Seri, professor of clinical neurophysiology and developmental neuropsychiatry3
  1. 1Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust and University of Birmingham, Birmingham, UK
  2. 2Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, UK
  3. 3School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, UK
  1. Correspondence to: A E Cavanna, Department of Neuropsychiatry, Barberry National Centre for Mental Health, Birmingham B15 2FG, UK a.cavanna{at}ion.ucl.ac.uk

Summary points

  • Tourette’s syndrome is a tic disorder that is often associated with behavioural symptoms

  • Diagnostic criteria are based on the presence of both motor and vocal tics; because of its varied presentations, the syndrome has the potential to be misdiagnosed

  • Prevalence is higher than commonly assumed; coprolalia is relatively rare (10-30%) and not required for diagnosis

  • The syndrome can cause serious distress and compromise health related quality of life

  • The main management strategies include psychoeducation, behavioural techniques, and drugs

  • Service provision is patchy even in developed countries and patients of all ages often “fall through the net” between neurology and psychiatry

Gilles de la Tourette’s syndrome, or Tourette’s syndrome, is a neurodevelopmental condition characterised by multiple motor and vocal tics, which appear in childhood and are often accompanied by behavioural symptoms.1 Originally described by French physician Georges Gilles de la Tourette in 1885,2 this syndrome has long been considered a rare medical condition, until large epidemiological studies showed that 0.3-1% of school age children fulfil established diagnostic criteria for this condition.3 4 In the United Kingdom, it is estimated that as many as 200 000-330 000 people are affected, with different degrees of severity.1 4 Although it is estimated that about two thirds of patients with GTS improve by adulthood the syndrome affects health related quality of life.5 This article reviews current knowledge about the diagnosis and management of Tourette’s syndrome, including drug treatments and behavioural interventions.

Sources and selection criteria

We based this review on articles found by searching Medline, the Cochrane Collaboration Library, Clinical Evidence, and the National Institute for Health and Care Excellence website with the term “Tourette”. Our search was limited to English language articles published between 2005 and 2012. We also used evidence from published studies and guidelines on the management and treatment of Tourette’s syndrome by …

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