Long-term Follow-up of a Case of Gilles de la Tourette's syndrome

Abstract

Gilles de la Tourette's syndrome is a combined vocal and multiple motor tic disorder. Here, we present a case of Tourette's syndrome who attended our psychiatric causality with severe depression and suicidal ideation. On reviewing follow-up records of 23 years, we come to know about the academic decline and nicotine dependence in the early childhood. He also developed co-morbid obsessive compulsive disorder (OCD) along with severe depression. He was agitated and self-injurious. We diagnosed him as Gilles de la Tourette's syndrome with co-morbid OCD, depression, nicotine dependence. The patient was treated with haloperidol, sertraline, and clonidine when he developed mixed switch that necessitated us to stop sertraline. Hence, he was treated with a mood stabilizer and he remitted. Here, we want to show how Tourette's syndrome can take a longer course with different co-morbidities in a single person's life. As per our knowledge, such presentation is relatively rare in Indian literature.

Behavior Therapy for the Treatment of Tourette’s Disorder in India: A Patient Series from an Indian General Hospital Psychiatric Unit

“…All the seven patients of this study had a fairly typical picture of TD. The slightly later age of onset was in keeping with Indian reports 9 , 12 and within the range of 4–15 years reported in cross-cultural studies among Asian populations. 3 However, it appeared that minor tics such as eye blinking at younger ages had been missed in some patients because of the lack of awareness among the parents.…”

“…Most patients appear to have been treated with medications, with the administration of repetitive transcranial magnetic stimulation (rTMS) or deep brain stimulation in patients resistant to medications. 10 , 11 Although HRT is mentioned in some instances, 12 , 13 there is virtually no information on the behavioral management of TD. Therefore, there is a need to examine whether behavioral treatments are equally effective for TD in routine clinical settings in India.…”