ABSTRACT
The disorder manifested by multiple motor tics, phonic and verbal productions, and behavioral changes was described by and named after Georges Gilles de la Tourette a century ago (Gilles de la Tourette, 1885). Over the last 100 years, a cascade of research studies has led to new and clearer appreciation of the phenomenology, natural history, etiology, physiology, and treatment of this malady. Moreover, Tourette's syndrome, as a prototypical illness, has become like a prism through which neuropsychiatry has been able to appreciate the various contributions to the clinical picture made by genetics, perinatal and stressful life events, inner life experience, family and relationship influences, and treatment efforts. There has been uniformly unanimous consensus that the multiple chronic motor and phonic symptoms first described by Gilles de la Tourette stand at the core of the disorder—the sine qua non of the syndrome. But various researchers have emphasized associated features that remain objects of intensive investigation even now. The study of these associated features has provided abundant opportunities to learn more and raise questions. Perhaps the most pressing question these studies have brought forward is whether associated features represent additional symptoms arising from the same etiology as the core syndrome or they are a secondary consequence of the core—the result of a complex interplay between urges, movements, self-control, and adaptation with which a Tourette sufferer is continually, painfully, and vividly confronted. The aim of this chapter is to review and distinguish the core symptoms, identify the variety of associated features that have been related to them, and discuss several of the most common instruments and methods of evaluation currently employed.
