Tics in childhood

The tic disorders represent a spectrum of disability ranging from simple transient tics of childhood to severe Tourette syndrome. Diagnosis depends on an awareness of their existence, willingness to accept the child and parents' histories, and appreciation of the broad range of symptoms. Although the etiology is not clear, some cases are familial. Environmental agents, especially psychostimulant drugs, may precipitate occasional cases. Treatment with haloperidol is useful for 80% to 85% of patients but associated with troublesome side effects in one-half of those treated. The long-term prognosis for complex tic disorders is not as bad as once thought, with improvement or remission often occurring in late adolescence. Abnormalities of central nervous system dopamine metabolism may be involved in the pathophysiology of the tic disorders.