© Springer-Verlag Italia 2015Angelo Sghirlanzoni, Giuseppe Lauria and Luisa Chiapparini (eds.)Prognosis of Neurological Diseases10.1007/978-88-470-5755-5_31
31. Extrapyramidal Diseases: Hyperkinetic Movement Disorders – Tics and Tourette Syndrome
Fondazione Giancarlo Quarta Milano, Milan, Italy
KeywordsTicHyperkinetic disordersTourette syndromeNatural history
Termino logy and definitions – Tics are semi-voluntary, sudden, rapid, brief, and non-rhythmic motor movements or phonic productions. Tourette syndrome (TS) is a neuropsychiatric disorder characterized by motor and phonic tics.
Clinical features – Tics may be simple, complex, transient or chronic. TS: motor and vocal tics; neuropsychiatric symptoms.
Diagnosis – Clinical.
Genetics – TS: significant multigene correlation.
Imaging – MRI (supporting role).
Top differential diagnoses – TS: tics; Obsessive-Compulsive Disease; Psychosis.
Principles of treatment – TICS and TS: antipsychotic drugs.
Disability – Intraindividual and interindividual variability quoad valetudinem.
ADHD, attention deficit hyperactivity disorder; OCD, obsessive–compulsive disease; TS, Tourette syndrome
31.1 Tic Disorders
Tics are semi-voluntary, sudden, rapid, brief, and non-rhythmic motor movements or phonic productions.
31.1.2 Clinical Features
Tics cause aimless and stereotyped motor actions (motor tics) and/or sounds (vocal tics) that are not suitable to the context. The patient declares he feels obliged to do it in order to release tension. It is possible to overpower such movements for a limited time by an endeavor of will, but the tics come back as soon as the subject’s attention is distracted.
Tics are classified as “simple” or “complex”. Simple tics implicate a restricted number of muscle groups. Complex tics, instead, involve several muscle groups.
“Transient tic” is the most usual tic disorder and may affect up to 20 % of children during the early school years, while “chronic tic” interests up to 5 % of children . Tics are defined “chronic” if present for 1 year or more.