We studied a large Mennonite kindred affected by chronic motor tics (CMTs) and vocal tics in a probable autosomal dominant pattern. We administered a standardized questionnaire to 69 family members and reviewed our videotapes of 47. Using DSM III criteria and independent ratings, we diagnosed 10 subjects as having definite Tourette's syndrome (TS), 3 with definite CMTs, 15 with probable TS, and 1 with probable CMT. The clinical features of this family are presented. This is the largest known kindred with TS. Permanent lymphoblastoid cell lines have been established from 67 family members for genetic linkage analysis.

We interviewed and examined 12 members of a single family affected by paroxysmal dystonic choreoathetosis. Three subjects experienced characteristic painful dystonic spasms, often precipitated by cold and prolonged physical activity. Three other family members suffered painful cramping of their limbs, without involuntary movement, following physical exertion. Based on the clinical features of affected subjects, we suggest that exertional cramping may represent a "forme fruste" of paroxysmal dystonia.

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