Bright Futures

Tourette Syndrome Awareness Month is May 15-June 15. For those who don’t know, Tourette syndrome (TS) is a chronic neurodevelopmental disorder that becomes evident in early childhood or adolescents. It is part of the spectrum of tic disorders. Individuals with TS have had at least two motor tics and at least one vocal tic in varying combination over the course of one year. Tics are involuntary repetitive movements and vocalizations. There are 3 kinds of tic disorders: Tourette syndrome, chronic motor or vocal tic disorder and provisional tic disorder, depending on the type of tics and their duration.

Tics are common in children, typically emerging between ages of 5 to 7 years. They tend to peak between ages of 8 and 12 years. Most people with TS show significant improvement in late adolescence. 1 out of every 160 children (0.6%) between the ages of 5 and 17 has TS in United States, and 1 out of every 100 children (1%) has TS or another tic disorder.

Tics are only a part of the symptom and disease complex seen in children with TS, or we could say “just a tip of the iceberg.” These patients often tend to have a host of co-occurring mental, behavioral or developmental conditions including anxiety, depression, obsessive-compulsive disorder or behavior, ADHD, learning disability, social skills deficit, sensory processing issues and sleep disorders.  In fact, these conditions may be the prime determinant of morbidity.

Initial treatment for tic and TS begins with the identification of disease extent, comorbidities and their functional implications in day-to-day life. TS is a chronic neuropsychiatric illness and thus it requires a teamwork amongst patient, family members, neurologist, developmental physician or psychiatrist and psychologist.

At Barrow Neurological Institute at Phoenix Children’s have a team of experts in these various specialties who help address these problems in children with TS. We also have a multidisciplinary complex Tourette Clinic (neurology, psychiatry and psychology) which gives a good platform to evaluate and discuss patients whose needs are not best met by independent specialty evaluations. We also work with psychologists and psychiatrists in the community to best serve the needs of our patients.

There is no cure for Tourette syndrome but there are various treatment options. Treatment modalities involve education, medications, psychotherapy/medications for mental health comorbidities and specific therapy for tics called Comprehensive Behavioral Intervention for Tics.

We enjoy a Center of Excellence status with the Tourette Association of America, which is a nonprofit organization committed towards raising awareness, advancing research and providing ongoing support to patients and families impacted by Tourette syndrome and tic disorders. We also work closely with Arizona chapter of the Tourette Association which conducts regular support group meetings for families and actively engages in education and raising awareness. Our center is also actively participating in research to help the shared goal of better treatment and understanding of this complex disease.