Diagnosis and treatment of tic disorders: literature review

Paulius Šidagis1

1 Vilnius University, Faculty of Medicine, Vilnius, Lithuania


Introduction. Tic disorders – complex neuropsychiatric disorders with onset usually occurring in childhood. Characterized by high comorbidity with other psychiatric disorders, especially attention-deficit/hyperactivity disorder, and obsessive-compulsive disorder. When proper treatment is not administered it can influence psychosocial functioning.

Aim of the study. To present an overview of tic disorders, their epidemiology, diagnosis, and treatment based on the newest evidence-based scientific literature.

Methodology. The literature search was conducted using Pubmed and Google Scholar databases. 20 studies published from 2010 to 2021 were selected, covering epidemiology, diagnosis, and treatment of tic disorders. Search keywords included: tic disorders, Tourette syndrome, epidemiology, diagnosis, and treatment. Exclusion criteria were applied for non-English studies, also studies covering the pathophysiology of tic disorders and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.

Results. Before beginning treatment, comprehensive clinical examination, identification of comorbidities, and differentiation from other movement disorders are essential. The main diagnostic instrument used to evaluate tic severity is – Yale-Global Tic Severity Scale. Treatment begins with psychoeducation for the patient and his family and supportive therapy. If necessary behavioral therapy can be suggested, mainly Comprehensive Behavioral Intervention for Ticks. If behavioral therapies are not possible or no improvement is measured medicines such as alpha-adrenergic agonists, typical and atypical neuroleptic, botulinum toxin injections can be introduced.

Conclusions. The main steps for diagnosis include clinical examination, differential diagnosis with other movement disorders, and identification of comorbidities. Treatment is started with psychoeducation and supportive therapy. Behavioral therapy and medication are only prescribed if necessary.


Keywords: Tic disorders, Tourette syndrome, diagnosis of tic disorders, treatment of tic disorders.