Tics and Tourette syndrome

J Paediatr Child Health. 2018 Oct;54(10):1148-1153. doi: 10.1111/jpc.14165.


Tourette syndrome is a heterogeneous disorder. The genetic basis is complex, and both in utero and ex utero environmental factors may modify the phenotypic expression of the disorder. Inflammation related to aberrations in immune activation appears to play a pathogenic role in some cases. Multiple neurochemical pathways are involved. Rather than being a pure movement problem, tics are now understood to also have a sensory component. This has resulted in new psychological therapeutic strategies and other potential treatments. Furthermore, comorbidities are common, particularly attention-deficit hyperactivity disorder, anxiety and obsessive-compulsive disorder, and often cause more difficulties than the tics. The approach to treatment is dependent on the degree and types of impairment. For many patients, education, acceptance and understanding are all that is needed. In more severe cases, psychological and/or pharmacological interventions may be indicated. In this article, the clinical features and pathophysiology of Tourette syndrome are reviewed, and a pragmatic management approach is discussed.

Keywords: Tourette syndrome; obsessive-compulsive disorder; tics.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adrenergic alpha-2 Receptor Agonists / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Behavior Therapy
  • Child
  • Comorbidity
  • Humans
  • Neuroimaging
  • Obsessive-Compulsive Disorder / complications
  • Tics / physiopathology
  • Tourette Syndrome* / diagnostic imaging
  • Tourette Syndrome* / etiology
  • Tourette Syndrome* / physiopathology
  • Tourette Syndrome* / therapy


  • Adrenergic alpha-2 Receptor Agonists
  • Antipsychotic Agents