The term “Tourette syndrome” (TS) refers to the association of motor and phonic tics with frequently occurring but varying degrees of psychiatric comorbidities.

Specifically, TS is characterized by the association of several motor tics and at least one phonic tic that are present for at least one year and appear before the age of 18. The diagnosis of TS is clinical and is based on the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, see Online supplement Annex 1).

Psychiatric comorbidities are also very common, and may include attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety disorders, explosive outbursts, self-injurious behaviors, learning disorders or autism spectrum disorder [1]. The condition begins in childhood, and evolves through a succession of periods of relative waxing and waning of tics. Improvement is observed by the end of the second decade of life in the majority of patients, but relevant symptoms may persist into adulthood in approximately one-third of patients [2].

The cause of TS is unknown, but genetic susceptibility and environmental factors appear to play a role.

The prevalence of TS is estimated at 0.5–1% of school-aged children, but this figure does not determine the percentage of people requiring medical follow-up [3]. Also, precise numbers for the adult population are not available at present.

The treatment of TS and severe forms of tics is often difficult and requires a multidisciplinary approach (including psychiatrists, neurologists, psychologists and social workers). In mild forms, education and psychological management are usually recommended. Medical treatments, including antipsychotics, are essential in the moderate to severe forms of the disease and they should be initiated as soon as necessary. Over the past decade, cognitive-behavioural therapies have been validated for the treatment of tics. For certain isolated tics, botulinum toxin injections may also be useful. Psychiatric comorbidities, when present, often require specific treatments. For very severe forms of TS, treatment with deep brain stimulation offers real therapeutic hope but long term follow up results of these patients are not available at present, so caution needs to exercised [4], [5].