A retrospective study of 58 adults with a diagnosis of Gilles de la Tourette’s syndrome (TS) during childhood is reported from the Department of Neurological Sciences, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, IL. The 41 men and 17 women had a mean current age of 27.1 years and a mean age of tic onset of 6.9 years. Forty six percent had a first degree relative with tics. All patients had tics as adults and most had both motor and phonic tics. Coprolalia occurred in 4% of adults. No patient experienced extreme adult disability and tics caused minimal to mild intrusion into private and professional life. All had received specialized medical care for TS in childhood, but only 26% were currently seeing a physician for tic disorders. Maximal disability had occurred during adolescence in most subjects, but 98% graduated high school, and 90% were full time students or fully employed. Childhood tic severity and coprolalia during development had no predictive value for risk of adult moderate/severe tics. Mild tic severity in adulthood correlated with mild tics during adolescence. [1]

COMMENT. In a study of TS in monozygotic twins, Hyde et al. at the National Institute of Mental Health, Washington, D.C. observed a significant effect of birth weight on the phenotypic expression of TS. Tic scores were greater in the lower birth weight twin as compared with the heavier group. Postnatal factors were not identified and did not play a major role in the subsequent expression of TS [2]. Global neuropsychological performance was more impaired in the more severely affected twin particularly in tests of attention and visuospatial perception [3]. Hypnosis was of benefit in reducing involuntary tics in 6 of 7 unmedicated children age 6 to 15 years with TS [4]. Deprenyl, an MAO-B inhibitor, was a safe and effective treatment of attention deficit disorder with hyperactivity in 80% of 20 children with TS. None of the patients noted exacerbation of their tics or other adverse side effects at doses up to 15 mg/day. [5]