Krishnan Gireesh

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INTRODUCTION: Tourette’s syndrome is a neurodevelopmental disorder commonly presenting in young males below 18 years of age and persisting for more than one year with multiple motor and vocal tics [1]. Tics are sudden, rapid, recurrent, and non-rhythmic motor movements or vocalizations commonly preceded by an urge [2]. Most cases of Tourette syndrome show significant improvement or resolve entirely by adulthood [3]. Patients whose tics persist into adulthood suffer from higher anxiety, low self-esteem, socioeconomic status, and poor quality of life [4]. Tourette syndrome is frequently associated with other common childhood disorders such as attention deficit hyperactivity disorder (ADHD) (60-80%), obsessive compulsive disorder (OCD) (11-80%), anxiety, depression (13-76%), migraine (25%) and self-injurious behaviour [5,6].According to the American Academy of Neurology’s practice guidelines, Tourette syndrome can be managed with behavioural, pharmacological, and surgical modalities [7]. Behavioural therapy includes exposure and response prevention therapy (ERP), habit reversal therapy (HRT), and comprehensive behavioural intervention for tics (CBiT), which is considered the safest and first line of treatment [4,7].CBiT is typically a behavioural intervention that includes psycho-education, HRT, functional analysis, and relaxation training and improves the patient’s recognition of the initial urge by providing a competing response or motor movement incompatible with the corresponding tic [8,9].