Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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What Treats Tourette's Syndrome?

Monday, 12 Jul 2010 09:11 AM

Question: What is the prognosis for a 12-year-old boy with Tourette's syndrome who does not present vocally, but has serious twitching and jumps? What would you recommend for treatment? Vitamins, etc.

Dr. Hibberd's Answer:

Children with Tourette's syndrome should be under the care of a psychiatrist with neurology consultation. There are very effective medicines that can be used to suppress the tics and involuntary movements, but he also needs behavioral and occupational therapy assistance. Start with your neurologist first, and work with your child's teachers to set up an appropriate intervention plan for schooling. Be sure to include a sensible, well-balanced diet free of additives, and a reasonably active physical education agenda.

Tourette's cases are highly variable in responses to medication, so I will defer the options to your consultants. Much of the time, these children end up on some form of major tranquilizer family (Haldol, Thorazine, or the newer generation Zyprexa, etc.) sometimes with an antiseizure /anticonvulsant added. Occasionally some additional mood-modifying agents are used as an adjunct.

Vitamin supplements and over-the-counter medicines have a role only when nutritional deficiencies co-exist, but they generally have little effect on the tics and outbursts of Tourette's patients unless there is a measurable deficiency or an amino acid disorder ( which should have been apparent on your initial pediatric workup and screening tests).

This said, some cases do respond to various dietary manipulations, but this explanation is too detailed to review here. Many children with Tourette's adjust quite well in later adolescence, so be sure to plan a sensible treatment plan with your consulatants to accomodate his educational needs, and be sure his academics are maintained.

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