Movement disorders in children: Tourette syndrome

Movement disorders in childhood are rare, but their occurrence is dramatic and frightening. Differential diagnosis depends primarily on a detailed evaluation of the history and an analysis of the characteristics of the movements. Tics are the most common movement disorder in childhood, ranging in severity for simple transient tics to the complex Tourette syndrome, which may be associated with many bizarre behaviors. Minimal defining characteristics of Tourette syndrome are the presence of multiple motor and vocal tics. Associated features may include echolalia, coprolalia, complex stereotyped movements, and compulsive behavior. There is a prominent familial occurrence of Tourette syndrome. Stimulant drugs may cause exacerbation of symptoms. The only consistency useful medication is haloperidol, but its use is associated with side effects in approximately 50% of the patients treated.