​Differential Diagnoses in Tourette Syndrome
​

 

Chronic tic disorder: Single or multiple motor or vocal tics (not both) occur for more than 12 months*
 

Transient tic disorder: Single or multiple tics occur for at least or more than 4 weeks but for 12 or less consecutive months*
 

Tardive Tourettism: Dyskinesia induced by neuroleptic drugs (antipsychotics) such as haloperidol, risperidone, pimozide etc
 

Epilepsy: Patient has seizures or fits usually with jerking movements & associated with loss of consciousness
 

Dystonia: twisting/contraction of specific muscle groups. Can affect face but typically the legs. Dystonia is usually progressive
 

Myoclonic epilepsy: A form of epilepsy in which jerking movements occur but without loss of consciousness
 

Affective Disorder: Depression is one of the most common misdiagnoses of Tourette Syndrome (CNS serotonin & nor-adrenaline tend to be low) - Depressive symptoms are a common finding in the majority of individuals with TS
 

Affective / Mood disorder: Bipolar Affective Disorder has been a frequent misdiagnosis
 

Autistic Spectrum Disorder/Asperger's: Many shared symptoms. NB: Can co-occur with Tourette Syndrome
 

Sydenham's Chorea: A movement disorder (St. Vitus Dance). Rheumatic fever common aetiological factor (75%)
 

ADD/ADHD: Very frequent misdiagnoses in TS. Attention deficit & hyperactivity are very common aspects of Tourette Syndrome
 

Allergy: Common misdiagnosis in the past. Carefully assess/eliminate possible hypersensitivity/allergans
 

Spasmodic torticollis: Including 'Wry Neck' > more prevalent between ages of 30 - 50 years
 

Psychosis/schizophrenia: Not a true differential as little symptom overlap > but misdiagnoses have occurred. The presence of neuroleptic side-effects can be a confusing factor (e.g. tardive dyskinesia / hyperkineses)