Headache in paediatric and adult patients with Gilles de la Tourette syndrome

Objective Gilles de la Tourette syndrome (GTS) is a neuropsychiatric disorder characterized by multiple motor and vocal tics and commonly associated with co-morbid conditions. Despite early reports of increased prevalence of headache in both children and adults with GTS, little is known about the nature of this co-morbidity. We conducted a collaborative study based in specialist clinics to compare the prevalence and characteristics of headache in paediatric and adult patients with GTS. Methods We assessed a total of 140 patients with GTS for the presence and characteristics of headache: 109 children and adolescents (age range 6-17 years) and 31 adults (age range 18-55, randomly selected from a clinical sample of 200 patients) seen at specialist clinics. A further comparison was performed between the group of adults with headache (n =15) and a subgroup of gender-matched children with headache (n =16). Results In our study, the prevalence of headache was 48.4% in adults with GTS and 22.9% in children with GTS (p = 0.01). Adults with GTS presented with higher tic severity and poorer quality of life compared to younger patients (p = 0.01). There was a significant difference in the headache types: tension type headache was significantly more commonly reported by adults with GTS, whereas migraine was significantly more commonly reported by children with GTS (p = 0.02). Adults with GTS and co-morbid headache consistently presented with higher tic severity and poorer quality of life compared to children with GTS and co-morbid headache (p = 0.01). Conclusions Headache is confirmed as a relatively common co-morbidity of GTS, particularly in adult patients seen at specialist clinics. The higher prevalence of headache in adults with GTS (especially tension-type headache) compared to younger patients could be related to higher tic severity and poorer quality of life in our adult clinical sample. If replicated, these findings can inform clinical practice in guiding targeted screening and management interventions for headache in patients with GTS across the lifespan.