Tourette’s syndrome is a complex, chronic neuropsychiatric disorder characterized by some form of involuntary, rapid, repetitive nonrhythmic movements or/and sudden vocal twitches with no apparent purpose. The twitching is experienced as unrestrainable but usually self-controlled for a period of time and is exacerbated by stress and disappears during sleep. It is often accompanied by behavioral and emotional disturbances such as compulsions, impulsivity, and hyperactivity. Tic disorder was first described by J.M.G. tard (1825) and Georges Gilles de la Tourette (1885), and until the 1960s was considered a rare, self-curing disorder of unknown origin. In China, it has been described as “hyperactivity obscura syndrome and habitual spasms”. Tourette’s syndrome was first named after Georges Gilles de la Tourette and is internationally known as Tourette’s syndrome (TS). The pathogenesis of the disease is still unknown, but it may be related to the following factors: (1) DA receptor (DR) hypersensitivity in the striatal system, which can be effectively controlled by DR antagonists, and, conversely, by amphetamine, which can significantly worsen tic symptoms. (2) The level of DA metabolite homovanillic acid (HVA) in the cerebrospinal fluid of the children was significantly reduced, and the degree of reduction was related to the severity of symptoms. Plasma tryptophan levels and the level of 5-HT metabolite 5-hydroxytryptophanic acid (5-HTP) in the cerebrospinal fluid were significantly reduced, and the degree of twitching was correlated with changes in the concentration of 5-HT metabolite 5-hydroxyindoleacetic acid (5-HIAA). suggesting the presence of abnormalities in 5-HT metabolism in TS. (iii) During early brain development, the excessive trophic effects of excitatory amino acids and sex hormones cause sustained depolarization of excitatory neurons. The disease is more common in males than females, suggesting that it is mainly related to androgens. ④ Chronic damage in the brain, mainly in the basal ganglia, caused by cytomegalovirus infection may also be an etiology of TS. In addition, some authors have reported the presence of anti-human caudate nucleus antibodies in the serum of affected children, suggesting that immune mechanisms may also be involved in this disease. In the last 30 years or so, there has been a dramatic change in the understanding of tic disorders, especially since the 1990s, and it is generally accepted that tic disorders are very common and are a neuropsychiatric developmental disorder caused by genetic defects and adverse environmental factors. The symptoms range from mild to severe and are complex and variable, manifesting not only as tics but also a variety of emotional and behavioral abnormalities. However, the medical community in China is still confused about this disease, treating the performance of these children as “bad disease”, “trachoma”, “conjunctivitis”, “pharyngitis “Even those who can identify the disease often delay treatment because of the view that it is “self-healing”. According to the survey, treatment delay or treatment confusion accounted for 75%, and the average delay in diagnosis is 3 years. Tic disorders are not uncommon, and studies have shown that they are actually very common, with a prevalence of 0.05% to 3%. For many years, many physicians believed that tic disorder was a self-healing disorder and that no specific treatment was necessary. However, this is not the case, and many patients have prolonged symptoms that are difficult to treat and even lead to lifelong disorders. In a comprehensive study of 3,500 patients with Tourette’s syndrome in 22 countries, 19.4% of patients who received treatment continued to have symptoms after the age of 16 years, with no reports of self-healing. The concept of self-healing has been analyzed to be mainly due to bias. Many people confuse transient tic disorder (less than 1 year in duration) with chronic tic disorder and Tourette’s syndrome, and therefore draw wrong conclusions. The age of onset is mostly from 3 to 12 years old, with an average of 7 years old, and it is more common in boys. Multiple twitching is the main symptom in the early stage, usually the first on the face, manifested as rapid and repeated irregular twitching of the eyes and facial muscles, such as blinking, nose twitching, “making a face”, later appear other parts of the motor twitching, such as head tossing, head nodding, rapid and short stretching of the neck, shrugging shoulders, symptoms can gradually to the upper limbs, trunk or lower limbs The symptoms may gradually develop to the upper extremities, trunk or lower extremities, with brief involuntary movements of the limbs or trunk, such as throwing movements of the upper extremities, kicking, kneeling, bending the knees, stubbing the feet or bending and twisting movements of the trunk. Frequent twitching can be more than a dozen or even hundreds of times a day. It is aggravated by emotion and nervousness and disappears during sleep. Vocal spasms are another characteristic of the disease. It often appears early in the course of the disease and can be manifested as simple vocal twitches or strange sounds, such as dry cough-like sounds in the throat, or overwhelming sounds such as barking, grunting, and “smacking”. “smacking”, “clicking”, and “squeaking” and “crunching” sounds. Nasal twitching is characterized by frequent snorting, gasping, and choking sounds. When the involuntary vocal twitching is cursing, it is called obscenity. The child has good self-awareness, but has difficulty in self-control. Vocal tics often occur during conversation, especially during pauses in speech. The frequency of vocal tics is particularly high when the child is under the influence of emotions or when the child is involved in personality and sexual content. 1/3 of the children often change their language in a particular way in order to hide the symptoms of vocal tics, which is counterproductive and results in slurred speech and uneven speech intensity. In some children, repetition of language occurs for fear that the meaning will be unclear, resulting in clinical repetitive language. The symptoms of Tourette’s syndrome range from mild to severe and are complex and variable, manifesting not only as tics but also as a variety of emotional and behavioral problems. It often leads to psychological distress in oneself and affects the daily life and learning of others. According to the survey, 60% of tics and obscenities are combined with ADHD, 59% with OCD, 15% with conduct disorder, 23% with learning difficulties, 20% with mood disorders, 18% with anxiety, 14% with self-injury, 20% with social skills problems, 25% with sleep problems, and 37% with temper control difficulties. Drug-refractory tic syndrome is characterized by severe symptoms and multiple muscle group tics, with a high number of combined psychiatric symptoms (64% of hyperactivity, 54% of behavioral problems, 52% of temper control problems, 31% of obsessive-compulsive, 22% of sleep disorders, and 20% of mood disorders). A small number of patients may have non-specific EEG abnormalities. The cranial CT/MRI shows bilateral asymmetry of the basal ganglia, larger caudate nucleus on the left side than on the right side, and mild enlargement of the lateral ventricles in some patients, while MRI sometimes shows bilateral reduction of the caudate nucleus and nucleus accumbens. There is no specific drug for this disease so far. In some patients, drugs such as haloperidol, thiopride and risperidone may be effective. Stereotactic radiofrequency therapy can relieve tic symptoms and improve the quality of life in some patients with drug-refractory disease.