Although Tourette syndrome (TS) appears to be ten times more prevalent in children than in adults, the time course of the condition is not well understood. This study followed 36 patients, born in 1975 and diagnosed with TS at Yale's Tic Disorders Clinic, to determine the course of tic severity during the first two decades of life.
Patients averaged 11 years of age at the time of diagnosis at the clinic and were interviewed for this study 6.5 and 7.5 years later. The mean age at onset of tics was about 6 years. Severity of TS at the time of diagnosis was not a good predictor of its severity years later. When patients were 18 years old, most had mild or no symptoms; only 4 patients (11 percent) had moderate or marked symptoms. A model developed to plot changes in severity over time suggested that tics were usually at their worst around five years after they began. From that point, there was a nearly linear annual decline in severity until early adulthood. The onset of puberty did not adversely affect tics.
Comment: Because the cause of TS is unknown, so also is the explanation for its diminution during adolescence. The authors are intrigued by the possibility of a neurobiologic cause. The study suggests that, as clinicians, we can extend an optimistic prognosis to the child and family and feel justified in deferring the use of psychotropic medications. --RA Dershewitz
Published in Journal Watch July 31, 1998
Source
Course of tic severity in Tourette syndrome: The first two decades
Leckman LF et al Course of tic severity in Tourette syndrome: The first two decades Pediatrics 1998 Jul; 102:14-19.[Full text of original article][Medline abstract][Download citation]
Course of tic severity in Tourette syndrome: The first two decades |