Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Tamara Pringsheim - , University of Calgary (Author)
  • Michael S. Okun - , University of Florida (Author)
  • Kirsten Müller-Vahl - , Hannover Medical School (MHH) (Author)
  • Davide Martino - , University of Calgary (Author)
  • Joseph Jankovic - , Baylor College of Medicine (Author)
  • Andrea E. Cavanna - , University of Birmingham (Author)
  • Douglas W. Woods - , Marquette University (Author)
  • Michael Robinson - , Tourette Association of America (Author)
  • Elizabeth Jarvie - , University of Wisconsin-Madison (Author)
  • Veit Roessner - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • Maryam Oskoui - , McGill University (Author)
  • Yolanda Holler-Managan - , Northwestern University (Author)
  • John Piacentini - , University of California at Los Angeles (Author)

Abstract

ObjectiveTo make recommendations on the assessment and management of tics in people with Tourette syndrome and chronic tic disorders.MethodsA 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.ResultsForty-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.

Details

Original languageEnglish
Pages (from-to)896-906
Number of pages11
JournalNeurology
Volume92
Issue number19
Publication statusPublished - 7 May 2019
Peer-reviewedYes

External IDs

PubMed 31061208

Keywords

ASJC Scopus subject areas