An unusual presentation of Tourette's syndrome

To report an unusual complex motor tic as the presenting symptom in a patient diagnosed with Tourette's syndrome.

This case report was compiled via interview with a 9-year-old white female who presented to the private gynecologic practice of the senior author. Additional history was gained from the patient's mother and follow up information was obtained from written and verbal communication with neurology colleagues.

Referral to neurology. Diagnosis of persistent perineal touching.

Diagnosis of Tourette's syndrome.

In young patients with nonspecific vulval symptoms, Tourette's syndrome should be considered in the differential diagnosis particularly if persistent self touching is a feature of the complaint. Referral to a physician experienced with the syndrome is important since the diagnosis is made on the basis of the clinical symptoms and signs.