Gilles de la Tourette syndrome: An overview

Gilles de la Tourette syndrome (GTS) is a neurodevelopmental condition characterized by multiple motor and vocal tics with a chronic course. With its multifaceted range of symptoms, GTS lies at the crossroads of neurology and psychiatry. This review article provides an outline of GTS, encompassing its extended clinical phenomenology, pathophysiology, and treatment options. Tics are the most common hyperkinetic manifestations in childhood, and the majority of patients present with comorbid behavioral conditions, such as obsessive-compulsive disorder, attention-deficit hyperactivity disorder, anxiety, and affective symptoms. Most patients report that their tics are preceded by sensory experiences (premonitory urges), i.e., unpleasant sensations characterized by pressure, tension, tightness, pain, itch, or vague inner discomfort. Tics can be temporarily suppressed and delayed for seconds to minutes, at the expense of mounting inner tension until the subjective feeling becomes unbearable, and the tic must be released. A better understanding of the mechanisms at the root of tic production can pave the way to the development of more effective treatment interventions for patients with GTS in order to improve their health-related quality of life (QOL). Specific instruments for measuring health-related QOL based on standardized assessments allow to appraise the impact of both tics and behavioral comorbidities and tailor treatment strategies to individual patients.