When is it appropriate to refer a patient with Tourette Syndrome to a specialist for further evaluation?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Referral to a specialist for a patient with Tourette Syndrome (a tic disorder) is appropriate under specific circumstances, varying slightly between children and adults .

  • For children:
    • Do not routinely refer children with simple motor tics that are not troublesome to the child .
    • Consider referral if the tic disorder has a significant impact on their quality of life . This may include:
      • Referral to mental health services if the tic disorder is associated with symptoms of anxiety or obsessive compulsive behaviour .
      • Referral to the neurodevelopmental team if the tic disorder is associated with symptoms suggestive of autism or attention deficit hyperactivity disorder (ADHD) .
      • Referral for neurological assessment if the tic disorder is severe .
    • Specialist referral and advice are required before offering medicine for motor tics .
  • For adults:
    • Do not routinely refer adults with tics unless the tics are troublesome or accompanied by additional progressive neurological symptoms .
    • Consider referring adults with a tic disorder for psychological therapy if the disorder distresses them .
    • Consider referring adults for neurological assessment if their symptoms are severe and the disorder continues to distress them after completing psychological therapy . It should be noted that there are limited medicines available, and they may not always be effective or can have serious side effects .

Educational content only. Always verify information and use clinical judgement.