Management of Severe Pediatric Tourette Syndrome Resistant to Drug Treatment

Tourette syndrome (TS) is a neurodevelopmental disorder with chronic and disabling impacts on multiple domains of functioning in children. Treatment of TS is often complicated by comorbid conditions. We present a 12-year-old boy with severe symptoms of Tourette syndrome (TS), with prominent and markedly disabling vocal tics, who failed to respond to substantial doses of risperidone and haloperidol, given for a prolonged period. Satisfactory outcome was achieved with exposure and response prevention, adjunct to medication. Comorbid ADHD was treated with stimulants with no exacerbation of tics.