Tourette's Disorder

Examinations and Tests

A doctor can diagnose Tourette's disorder (TD) based on your child's medical history and the kinds of tics and other symptoms you and other caregivers have noticed. As with many other conditions, testing to look at brain function or substances in blood may be done but can't be used to confirm a diagnosis of TD.

Children may suppress their tics while they are in the doctor's office, so it may help to bring a videotape that shows your child's tics. But doctors may diagnose TD even though they have not seen a video or observed any tics during the child's office visit.

Your doctor will ask you and sometimes other people who have regular contact with your child questions about school and other areas of your child's life. You, your child, or the doctor can also use assessment tools, such as the Yale Global Tic Severity Scale or the Tourette's Disorder Scale, to help the doctor get a better sense of how your child is doing. Your child may need psychological testing and testing for learning problems.

Tourette's disorder may be diagnosed using the following criteria:²

• Tics begin before the age of 18 years. Tics that begin after age 18 are not considered to be caused by Tourette's disorder.
• Both body movements (motor tics) and sounds or words (vocal tics) are present (although not always at the same time) and have lasted for at least 1 year.
• Tics occur many times a day (usually in bursts) and nearly every day. Tics never disappear for longer than 3 months.
• Tics are not caused by another condition, such as seizures, or by medicines.

Tourette's disorder can be difficult to diagnose, because other tic disorders can cause motor movements and/or vocal sounds. Tests that may be done to check for other conditions include:

• An EEG or a CT scan of the head to see whether your child has seizures or other brain problems.
• Blood tests to check for other conditions, including overuse of certain medicines (such as amphetamines); pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), which can affect tic development; or rare medical conditions, such as not being able to break down copper in the body (Wilson's disease).

Because attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and other conditions such as depression are often associated with Tourette's disorder, your child's doctor may also look for signs of these problems. For more information, see the following topics:

Attention Deficit Hyperactivity Disorder (ADHD)

Obsessive-Compulsive Disorder (OCD)

Depression in Children and Teens

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Author:	Debby Golonka, MPH Maureen Shea	Last Updated: November 15, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Karin M. Lindholm, DO - Neurology Andrew Swan, MD, CCFP, FCFP - Family Medicine
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