Practice Guideline Recommendations Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders

Authors

Tamara Pringsheim, University of Calgary
Michael S. Okun, University of Florida - GainesvilleFollow
Kirsten Muller-Vahl, Hannover Medical School
Davide Martino, University of CalgaryFollow
Joseph Jankovic, Baylor College of Medicine
Andrea E. Cavanna, University of Birmingham and Aston University
Douglas W. Woods, Marquette UniversityFollow
Michael Robinson, Tourette Association of AmericaFollow
Elizabeth Jarvie, University of Wisconsin - Madison
Veit Roessner, Technische Universitat Dresden
Maryam Oskoui, McGill University
Yolanda Holler-Managan, Northwestern University
John Piacentini, University of California - Los AngelesFollow

Document Type

Article

Language

eng

Publication Date

5-2019

Publisher

American Academy of Neurology

Source Publication

Neurology

Source ISSN

0028-3878

Abstract

Objective

To make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.

Methods

A multidisciplinary panel consisting of 9 physicians, 2 psychologists, and 2 patient representatives developed practice recommendations, integrating findings from a systematic review and following an Institute of Medicine–compliant process to ensure transparency and patient engagement. Recommendations were supported by structured rationales, integrating evidence from the systematic review, related evidence, principles of care, and inferences from evidence.

Results

Forty-six recommendations were made regarding the assessment and management of tics in individuals with Tourette syndrome and chronic tic disorders. These include counseling recommendations on the natural history of tic disorders, psychoeducation for teachers and peers, assessment for comorbid disorders, and periodic reassessment of the need for ongoing therapy. Treatment options should be individualized, and the choice should be the result of a collaborative decision among patient, caregiver, and clinician, during which the benefits and harms of individual treatments as well as the presence of comorbid disorders are considered. Treatment options include watchful waiting, the Comprehensive Behavioral Intervention for Tics, and medication; recommendations are provided on how to offer and monitor these therapies. Recommendations on the assessment for and use of deep brain stimulation in adults with severe, treatment-refractory tics are provided as well as suggestions for future research.

Comments

Published version. Neurology, Vol. 92, No. 19 (May 2019) : 896-906. DOI. This article is © 2019 American Academy of Neurology. Used with permission.

Recommended Citation

Pringsheim, Tamara; Okun, Michael S.; Muller-Vahl, Kirsten; Martino, Davide; Jankovic, Joseph; Cavanna, Andrea E.; Woods, Douglas W.; Robinson, Michael; Jarvie, Elizabeth; Roessner, Veit; Oskoui, Maryam; Holler-Managan, Yolanda; and Piacentini, John, "Practice Guideline Recommendations Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders" (2019). Psychology Faculty Research and Publications. 452.
https://epublications.marquette.edu/psych_fac/452