Brief, rapid, recurrent, and seemingly purposeless stereotyped muscle contractions. Gilles de la Tourette syndrome (TS) is a neurobehavioral, multiple tic disorder that may involve motor tics (especially twitches of the face, neck, and shoulders) and phonic tics (grunts, words, coprolalia, echolalia). Pts may experience an irresistible urge to express tics but characteristically can voluntarily suppress them for short periods of time. Onset is usually between 2 and 15 years of age, and tics often lessen or even disappear in adulthood.

• Drug treatment is only indicated when tics are disabling and interfere with quality of life.
• Therapy is generally initiated with clonidine, starting at low dose, or guanfacine (0.5-2 mg/d). If these agents are not effective, neuroleptics may be used.