Tourette syndrome is a severe neurological movement disorder characterized by tics, which are involuntary, repeated, intermittent movements, or vocalizations. It is a genetic disorder that commonly presents in boys and is often associated with attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). Diagnosis is based upon multiple motor tics and at least one vocal tic, lasting for longer than a year, and the exclusion of other suspected medical conditions. Treatment is symptomatic and includes behavioral therapy and dopamine antagonists. Approximately 50% of cases resolve by adulthood.
- Sex: ♂ > ♀ 
- Age of onset: usually 4–6 years of age (tics are most severe between 10–12 years of age and then decline during adolescence) 
Epidemiological data refers to the US, unless otherwise specified.
Tics: sudden and rapid involuntary, intermittent, nonrhythmic movements or vocalizations without any recognizable purpose
- Temporarily suppressible
- An urge or sensation preceding the tic is relieved by its onset.
|Vocal tics|| || |
|Motor tics|| || |
Tourette syndrome is a clinical diagnosis based on all of the following:
- Other tic disorders 
- Sporadic transient tic disorder: a subtype of tic disorder particularly common in children, which manifests with motor or vocal tics that occur over a period of less than one year before resolving.
- Persistent motor tic disorder or persistent vocal tic disorder are subtypes of tic disorder particularly common in children, which manifests with motor or phonic tics only.
Stereotypic movement disorder
- Stereotypic, uncontrolled, repetitive movements lasting ≥ 4 weeks
- More common in children, especially boys, with neurological disorders and developmental delay
- Includes rocking movements, hair pulling, hair twisting, and self-destructive behavior (e.g., head banging, picking at skin, hitting oneself) 
The differential diagnoses listed here are not exhaustive.
- Support: counseling and education (for both caregivers and patients)
- Indicated for mild, nondisabling symptoms
- Involves habit reversal training or Comprehensive Behavioral Intervention for Tics (CBIT)
Medical therapy 
- Indicated for severe or refractive cases despite behavioral therapy
- Alpha-adrenergic agonists: guanfacine; (often first-line therapy), clonidine (very sedating)
- Typical neuroleptic drugs: pimozide, haloperidol, fluphenazine (FDA-approved but may cause )
- Atypical neuroleptic drugs: risperidone (increasingly preferred because of fewer side effects)
- Dopamine depleting drugs: tetrabenazine (may be used as first-line therapy to avoid side effects of neuroleptic drugs, i.e., dopamine blockade) 
- Deep brain stimulation (DBS): an alternative therapy in therapy refractory cases with severe tics 
- Symptoms improve during adolescence. 
- May resolve spontaneously by 18 years of age (50% of cases)