Tourette's syndrome manifests as chronic persistent cough.

Tourette's syndrome (TS) is a neuropsychiatric disorder characterized by the presence of involuntary motor and phonic tics. Phonic tics can mimic respiratory system disorders such as asthma, and upper and lower respiratory system infections. We report on twins with chronic persistent cough (CPC): one of whom was followed as an asthmatic for a year and the other was diagnosed with recurrent respiratory tract infection. A careful history and neurologic assessment suggested that TS might be responsible for the first twin's symptoms but that the second one was probably in early TS. All the symptoms of the first patient diagnosed as TS showed a complete improvement with pharmacological treatment in two weeks. Since the history of CPC may in reality be TS, we recommend that TS should be considered in the differential diagnosis of pediatric CPC.