Tourette syndrome: recent advances.

In spite of new information relevant to the clinical and biological features of Tourette syndrome, areas of controversy still exist. A genetic substrate is present in at least some affected families; there also is clearly a genetic relationship between Tourette syndrome and chronic motor tic disorder. Patients with Tourette syndrome have an increased incidence of behavior problems, attention deficit disorder, and obsessive-compulsive symptoms. Treatment of the attention deficit disorder with psychostimulant drugs will exacerbate tics in some patients. Haloperidol remains the most consistently useful therapeutic agent. Pimozide and clonidine also may be useful, but further work is required before standard treatment protocols can be developed. The disorder most likely results from dysfunction of dopaminergic systems.