Pediatric Tourette Syndrome (TS) is a neurological condition causes due to repetitive, involuntary movements and vocalizations. 

It is a neurodevelopmental disorder that starts in childhood and occurs by motor and phonic tics. 

In 1885, French neurologist Gilles de la Tourette presented 9 cases of childhood-onset and in 1960, neuroleptic medications were discovered beneficial for TS tics. 

A genetic disorder inherited from families that impacts individual’s quality of life, especially when combined with other behavioural disorders. 

TS is a global disease which affects all social classes and races with current diagnostic cases reported in the United States, Japan, Europe, and New Zealand. 

Tourette Syndrome is a rare condition that affects 1 child out of 160 children’s and in that boys are more affected three to four times more than girls. 

The pathophysiologic mechanisms of TS are yet to be determined, but every study shows it is an inherited developmental disorder of synaptic neurotransmission. 

Dopamine plays an important role in regulating motor function and is known to affect the expression of tics. 

Serotonin pathway dysfunction may lead to obsessive-compulsive symptoms observed in children with TS. 

The exact cause of TS is unknown, but most evidence suggests it is an inherited developmental condition. 

Dysfunctions in the dopaminergic and serotonergic systems may lead to the motor and behavioural symptoms observed in TS.  

Symptoms of tics become unpredictable, changing daily or weekly, but later teenage years often see a levelling of severity and remission. 

Two-thirds of children with TS can expect significant improvement in their tics or almost complete remission. 

Individuals with a family history of TS are at a higher risk of experiencing persistent symptoms or developing related conditions. 

TS is starts in childhood, with symptoms appearing between ages 2 and 12 and with an average onset age of around 7 years old. 

Assessment of Motor and Vocal Tics 

Neurological Evaluation 

Evaluation of Functional Impairment 

Parents or caregivers may initially observe mild motor or vocal tics that gradually increase in frequency or intensity over time. 

Parents may observe behaviors like frequent eye blinking, facial grimacing, throat clearing, sniffing, or repetitive movements. 

Patients should register them in psychiatric assessment and stabilization program to evaluate tic symptoms, associated comorbid conditions, functional impairment, and psychosocial factors. 

Give psychoeducation to children and their family, so this will help to engage them in treatment and mention all concerns related to their health. 

Necessary care should be given under observation of a physician, so it will stabilize the patient’s health condition. 

Appointments with medical physicians and preventing recurrence of disorder is an ongoing life-long process. 

Pediatrics, General

Provide treatment setting in a safe and supportive environment to minimize potential triggers for Tourette syndrome.  

Give education to family members to help them understand pediatric Tourette syndrome and how to deal with this challenge.  

Pediatric patient should maintain routines in daily activities including meal on time and sleep on time can help reduce anxiety and enhance overall functioning. 

Pediatrics, General

Haloperidol: It has antipsychotic properties and is a dopamine D2 receptor antagonist which blocks dopamine receptors in the brain. 

Pimozide: It is used for treating severe and disabling tics in TS, in children and adolescents. It is effective in reducing motor and vocal tics with fewer sedative effects. 

Pediatrics, General

Risperidone: It is a selective monoamine antagonist with high affinity for serotonin 5-HT2 and dopamine D2 receptors, targeting dopamine receptors in the limb system. 

Aripiprazole: It is indicated for Tourette syndrome in children aged from 6 to 18 years which works as a partial agonist at dopamine D2 and serotonin type 1 receptors. 

Pediatrics, General

Ropinirole: It is a dopamine agonist exhibits high specificity and intrinsic activity at the D2 subfamily of dopamine receptors and binds with greater affinity to D3 than D2. 

Pediatrics, General

Deep brain stimulation is a surgical procedure that involves implanting electrodes into specific brain areas and delivering electrical impulses. 

The procedure to treat this syndrome involves comprehensive behavioral intervention and psychosocial support. These all procedures are performed by physicians as per the need and condition of pediatric patient.  

Pediatrics, General

In the initial diagnosis phase, the physician assesses symptoms related to Tourette syndrome, physical examination, neurological evaluation, and psychological assessment. 

The regular follow-up visits with medical physicians are required to check the improvement of patients and newly observed complaints. 

Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.