New guidelines for Tourette and chronic tic disorders

  • Neurology

  • International Clinical Digest
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Takeaway

  • For treating Tourette syndrome and chronic tic disorders, clinicians can turn to this set of practical guideline recommendations endorsed by the Child Neurology Society and the European Academy of Neurology.

Why this matters

  • A key consideration is whether the tics interfere with daily life, and all treatments should be individualized from this starting point.

Key recommendations

  • Watchful waiting can be appropriate if tics are not disruptive.
  • Any treatment should be individualized and based on a collaborative decision among the affected person, any caregivers, and the clinician.
  • Children can be advised that tics can improve with age sometimes.
  • A first-line treatment is behavioral intervention ( Comprehensive Behavioral Intervention for Tics ).
  • Assessment should be made for common co-occurring conditions (e.g., obsessive-compulsive disorder, ADHD).
  • Awareness of drug side effects and interacting conditions is crucial.
  • Botulinum toxin injections are potentially an option for older adolescents, adults.
  • For refractory tics, deep brain stimulation might be on the table, following screening and with continuous monitoring.
  • The guidelines address the growing question of the utility of cannabis and associated legal issues.

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