Tourette's%20syndrome%20-and-%20other%20tic%20disorders Signs and Symptoms
Definition
Tics
- Sudden, rapid, non-rhythmic, repetitive, motor movements or vocalizations
- Mean age of onset is approximately 5 years with peak severity occurring between 10-12 years of age and declining in many children during adolescence
- There is a strong genetic component showing a 10- to 100- fold increase in the rates of tics & Tourette syndrome (TS) among 1st-degree relatives of Tourette syndrome patients
Etiology
Primary Causes of Tic Disorders
Inherited Tic Disorders
- Tourette syndrome (TS)
- Huntington’s disease
- Primary dystonia
- Neuroacanthosis
Sporadic Tics
- Transient motor or phonic tics (<1 year duration)
- Chronic motor or phonic tics (>1 year duration)
- Adult-onset (recurrent tics)
- Tourette syndrome
Secondary Causes of Tic Disorders
Primary Neurologic Disorders
- Head trauma
- Stroke
- Encephalitis
- Carbon monoxide poisoning
- Neurosyphilis
- Sydenham’s chorea
- Hypoglycemia
- Down syndrome
- Tuberous sclerosis
- Fragile X syndrome
- Klinefelter’s syndrome
- Chromosomal disorders
- XYY karyotype
- Duchenne’s disease
- Hallervorden-Spatz disease
- Creutzfeldt-Jakob disease
Primary Neuropsychiatric Disorders
- Mental retardation
- Schizophrenia
- Asperger’s syndrome/autism
Drugs Which May Induce or Worsen Tics
- Stimulants (eg Methylphenidate, Amphetamines, Pemoline)
- Cocaine
- Antipsychotics
- Antidepressants
- Anticonvulsants
- Antihistamines
- Lithium
- Opioids & opioid withdrawal
- Levodopa
Other movement disorders that need to be ruled out:
- Eg myoclonic movements, torsion dystonia, chorea, stereotypies