Parkinson's Disease and Movement Disorders

Tourette Syndrome

Tourette's syndrome is a chronic tic disorder in a patient who has had tics and symptoms that began before age 18. Patients with tic disorders frequently have other psychiatric issues, such as obsessive-compulsive disorder, attention deficit disorder, anxiety, and phobias. The causes of Tourette's syndrome and other tic disorders are unknown, but research suggests they arise from abnormalities in specific regions of the brain and the circuitry that connects these regions.

NewYork-Presbyterian Hospital's neurologists work with other specialists to diagnose and treat patients with Tourette's syndrome. In addition to medical care for their tics, patients may receive care for related psychiatric symptoms from NewYork-Presbyterian's renowned Departments of Psychiatry.

Symptoms

People with Tourette's syndrome may display repetitive involuntary movements (such as eye blinking, facial grimacing, or shoulder shrugging) or vocalizations (such as throat clearing, coughing, barking, or grunting). People with more complex vocalization patterns may repeat whole words or phrases uncontrollably.

Diagnosis

NewYork-Presbyterian's healthcare professionals perform a comprehensive evaluation of the patient's psychological, social, and educational status and complete a thorough medical, developmental, and family assessment. A detailed history of a child's behavior from parents and teachers, in addition to observations of the child's behavior, are useful in making the diagnosis.

Tourette's syndrome may have a genetic component. For this reason, genetic counseling is available at NewYork-Presbyterian for families of people diagnosed with Tourette's syndrome.

Treatment

NewYork-Presbyterian's neurologists treat Tourette's syndrome with different types of medications, including those that can reduce the frequency and intensity of tics by altering the levels of certain brain chemicals. Patients may also receive medication for associated anxiety disorders, which can reduce the severity of symptoms and improve overall quality of life.

If Tourette's syndrome is severe and does not respond to medical treatment, doctors may consider surgical treatment. "Deep brain stimulation" (DBS) has become an important tool in the treatment of Tourette's. NewYork-Presbyterian is one of the busiest and most prestigious centers offering this treatment. With DBS, neurosurgeons implant a device that acts like a pacemaker for the brain, reducing or eliminating the activity of the areas overly active in Tourette's and minimizing symptoms. DBS also enables many patients to reduce their dependence on medications.

Rehabilitation

For some patients, behavioral techniques (such as biofeedback or relaxation methods) can alleviate the stress that can trigger tics. Other support services can also be helpful for patients with behavioral difficulties related to a tic disorder. All of these services are available at NewYork-Presbyterian Hospital.

Research and Clinical Trials

Investigators at both NewYork-Presbyterian Hospital campuses are conducting basic science and clinical research to learn more about the causes of Tourette's syndrome and other tic disorders and to find new and more effective ways to diagnose and treat them.