Synonyms:
Gilles de la Tourette’s syndrome
Diagnosis:
Clinical criteria:
- Onset < 21 y.o.
- Lasts >1 year.
- Multiple motor tics. At least 1 vocal tick. Fluctuating course.
- Corprolalia is not necessary for diagnosis
- Consider associated:
- Attention deficit hyperactivity disorder ADHD
- Obsessive compulsive disorder OCD
Treatment:
Educate patient, family members, teachers.
Decide on if treatment is warranted
Social: Extra breaks at school & additional test taking time.
Motor Tics:
- 1st line: Fluphenazine
- Pimozide, [Metanalysis].
- Haloperidol, trifluoperazine
- Consider: botulinum toxin injection
If attention deficit is present: treat it
- Clonidine orally, then patch
- Haloperidol
If obsessive compulsive:
- Clomipramine P.O. or others
If impulsive:
- Carbamazepine CBZ or lithium.