Tourette syndrome

Background

• Tourette syndrome is a neuropsychiatric disorder characterized by multiple motor and vocal tics
• Onset typically in childhood (mean age 6-7 years)
• Tics wax and wane in severity over time
• Often comorbid with ADHD and OCD

Clinical Features

• Multiple motor tics (eye blinking, head jerking, facial grimacing)
• At least one vocal tic (throat clearing, sniffing, coprolalia)
• Tics present for >1 year
• Onset before age 18

Differential Diagnosis

• Transient tic disorder
• Chronic motor or vocal tic disorder
• Drug-induced tics
• Chorea

Evaluation

• Clinical diagnosis based on history and observation
• No specific laboratory or imaging studies required

Management

Antibiotic Dosing

Adult

• Quinine 0.25-3 mg/day PO divided daily-BID (max 6 mg/day)

Pediatric

• Quinine 0.75-3 mg/day PO divided daily/BID

Disposition

• Outpatient management
• Neurology referral for medication management

See Also

• Chorea