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Gilles de la Tourette's syndrome 

Gilles de la Tourette's syndrome
Chapter:
Gilles de la Tourette's syndrome
Author(s):

Ivan Donaldson

, C. David Marsden

, Susanne A. Schneider

, and Kailash P. Bhatia

DOI:
10.1093/med/9780192619112.003.0753
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date: 06 March 2021

The historical aspects of Gilles de la Tourette’s syndrome are covered in the Introduction to ‘Tics’, Section 6. As mentioned above, however, the borderland between simple tics and Gilles de la Tourette’s syndrome is not entirely sharp. Simple tics may give way to multiple tics and the latter may become chronic or permanent, without the picture being that of full-blown Gilles de la Tourette’s syndrome. This has led to the intermediate category of ‘multiple tics’. That is not to say that the simple tic disorder of childhood cannot exhibit more than one tic type, but these are usually few in number and one tic tends to be replaced by another. In multiple tic disorders there may be quite a large number of tic types, which can occur contemporaneously or serially. Frequently several tic types are present at any stage. In order to be regarded as a chronic tic disorder, symptoms should have been present for more than 1 year (Shapiro and Shapiro 1986). Average age of onset of such tics has been said to be about 9 years (Shapiro and Shapiro 1986), but there are little published data on this and with the exception of involuntary vocalizations, they seem identical to Gilles de la Tourette’s syndrome. In addition, chronic multiple tics are common in families of patients with Gilles de la Tourette’s syndrome and a monozygotic twin pair may contain both of these disorders (Price et al. 1985, Randolph et al. 1993). As involuntary vocalizations seem to be only another form of tic, and the clinical profile, including response to treatment, is similar in both groups, further discussion of multiple tics is included with Gilles de la Tourette’s syndrome.

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