Hi wasabi, part of getting to a diagnosis of TS would be to rule out secondary causes. There are also many primary neurological conditions which manifest tics.
A diagnosis of Tourette's Disorder as stated in DSM IV-TR
e.g. "• the disturbance must not be due to the direct physiological effects of a substance (e.g. stimulants) or a general medical condition (e.g. Huntington's disease or postviral encephalitis)."
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MEJIA, Nicte ; JANKOVIC, Joseph.
Secondary tics and tourettism
Rev. Bras. Psiquiatr.,
São Paulo, v. 27, n. 1, 2005.
http://www.scielo.br/pdf/rbp/v27n1/23707.pdf
for some reason that pdf won't load for me this morning. Here's the same thing in html... sorry about the keyword highlights.
http://72.14.253.104/search?q=cache:...ient=firefox-a
Is it a tic or Tourette's?
Clues for differentiating simple from more complex tic disorders
Virgilio Gerald H. Evidente, MD
http://www.postgradmed.com/issues/20...idente_tic.htm
Quote:
Several conditions, termed tourettism, may mimic Tourette's syndrome. Drugs, including stimulants, levodopa (Dopar, Larodopa), and antiepileptic medications (eg, phenytoin [Dilantin], carbamazepine [Atretol, Epitol, Tegretol], lamotrigine [Lamictal]), may cause tourettism. Discontinuation of the offending drug leads to prompt remission of the tics. Neuroleptic medications with potent dopamine2 (D2) antagonist activity (eg, haloperidol [Haldol]) may cause tardive tourettism, which presents with delayed and often permanent tics identical to Tourette's syndrome.
Other causes of tourettism include infections (eg, Creutzfeld-Jakob disease, encephalitis), toxins (eg, carbon monoxide), Huntington's disease, head trauma, stroke, neuroacanthocytosis, chromosomal abnormalities, cerebral palsy, neurocutaneous syndromes, and schizophrenia
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Recognition and Management of Tourette's Syndrome and Tic Disorders
MOHAMMED M. BAGHERI, M.D., JACOB KERBESHIAN, M.D., and LARRY BURD, PH.D.
http://www.aafp.org/afp/990415ap/2263.html
Secondary Causes of Tic Disorders
Quote:
Primary neurologic disorders manifesting tics
Acquired- Head trauma
- Encephalitis
- Stroke
- Sydenham's chorea
- Carbon monoxide poisoning
- Creutzfeldt-Jakob disease
- Neurosyphilis
- Hypoglycemia
Genetic- Huntington's disease
- Neuroacanthocytosis
- Hallervorden-Spatz disease
- Idiopathic dystonia
- Duchenne's disease
- Tuberous sclerosis
- Chromosomal disorders
- Down syndrome
- Klinefelter's syndrome
- XYY karyotype
- Fragile X syndrome
Primary neuropsychiatric
disorders manifesting tics
- Schizophrenia
- Asperger's syndrome/autism
- Mental retardation
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[These lists don't include everything. Wilson's Disease is also a disease where the patient might present with tics. There have been other medications implicated over the years in individual patients and also lightning stike. I remember we used to have a forum member years ago whose son was eventually found to have a brain tumour which was causing the tics. Also, to confound all this, some people with say Asperger's Syndrome or Autism may also have tics, but a small percentage can actually have Tourette Syndrome as well. There is a LOT of information available about this subject if you need any more.]
p.s.
[Remember the book called Awakenings, by Oliver Sacks? It was also made into a movie. Well the illness that those people had was a type of encephalitis called Encephalitis Lethargica and motor and vocal tics as well as compulsions were reported in those patients... that was way back in the early 1900's].