Tourette syndrome is now recognised as affecting 1% of school-age children and covers a wide range of severity ranging from a diagnostic combination of mild and simple motor and vocal tics to a severely intrusive movement disorder with associated co-morbidities, the most common of which are obsessive–compulsive disorder and attention deficit hyperactivity disorder. It is a familial condition, but the genetic mechanism has yet to be identified. The neurobiology is also still not understood, and the major research themes are neuroimaging and neuroimmunology, with a controversial hypothesis relating to basal ganglion antibodies secondary to group A streptococcal infection. Management is with psychological techniques, neuroleptic drugs, clonidine, stimulants and selective serotonin uptake inhibitors. Most recently, deep brain stimulation to the basal ganglia or thalami has been applied in adults, but substantial data in this area are awaited.
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