Tourette’s Syndrome Service

Ryegate garden

Tourette’s syndrome is a neurodevelopmental disorder characterised by motor or vocal tics.

The syndrome usually becomes apparent in children by the age of 10, with tics appearing during stressful and emotional situations. By the age of 18 more then 80% of individuals are tic free.

We hold a Tourette’s syndrome clinic three times a year at the Ryegate Children’s Centre. The clinic specialises in evaluating, diagnosing and treating children and adolescents with symptoms of Tourette’s syndrome including tics, hyperactivity, attention deficits, obsessive compulsive behaviors and other symptoms.

The Tourette’s Syndrome Service provides:

  • comprehensive diagnostic assessment for children and adolescents
  • family assessment and treatment
  • clinical psychology support
  • pharmacological management and follow-up
  • liaison with schools and community agencies

About Tourette’s

Tourette’s syndrome is a neurodevelopmental disorder characterised by motor and vocal tics – rapid, repetitive, stereotyped movements or vocalisations. Boys are more commonly affected than girls.

Symptoms usually begin with transient bouts of simple motor tics. By age 10 years, most children are aware of nearly irresistible somatosensory urges that precede the tics; a momentary sense of relief typically follows the completion of a tic.

Over the course of hours, tics occur in bouts with waxing and waning periods.

Tics increase during periods of emotional excitement and fatigue.

Tics can become ‘complex’ in nature and appear to be purposeful. They can be voluntarily suppressed for brief intervals and can be evoked by the mere mention of them. Tics typically diminish during periods of goal-directed behaviour, especially those that involve both heightened attention and fine motor or vocal control, as occur in musical and athletic performances.

New tics appear, often in response to new sources of irritation, such as the appearance of a persistent vocal tic (a cough) following a cold.

Over the course of years, tic severity typically peaks between 8 and 12 years of age.

By the end of the second decade of life, many individuals are virtually tic free. Less than 20% of cases continue to experience clinically impairing tics as adults.

Tics rarely occur in isolation, and other coexisting conditions such as behavioural disinhibition, hypersensitivity to a broad range of sensory stimuli, problems with visual motor integration, procedural learning difficulties, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depression, anxiety, and emotional instability are often a greater source of impairment than the tics themselves.

Getting a referral

Children and adolescents can be referred to the clinic by their GP, general paediatricians, community paediatricians, child psychiatrists and other health professionals working in the local education authority. Referral letters should be sent to Dr S Mordekar, Clinical Lead for paediatric movement disorders and Tourette’s syndrome, who will then send an appointment.

Clinic appointment

The child and their family will be seen by Dr Santosh Mordekar and his team, who will take history and clinical assessment. Information and various treatment options will be discussed for your child following diagnosis.

Liaison with local paediatric teams and local education authorities is provided with your consent. Individual management and follow up plan will be agreed.

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