Tourette's syndrome: an expanded view.

Tourette's syndrome is a disorder of central nervous system functioning in which the most easily recognized symptoms of involuntary movements and vocalizations have been found to be responsive, in many cases, to pharmacotherapy with haloperidol. We have recently evaluated five patients with Tourette's syndrome and have been impressed with the learning difficulties, speech and language problems, and behavioral problems which accompanied the involuntary neuromotor manifestations. These lesser known manifestations were not improved with haloperidol, and in fact, the sleepiness associated with the use of haloperidol was thought to adversely affect school performance in two of our patients. Thus, a holistic approach to the evaluation and treatment of children with Tourette's syndrome is recommended. Early attention to possible speech and language difficulties, appropriate academic help, and counseling regarding behavior management are seen as management issues at least as important as medication management.