Tourette syndrome and Tics are a group of unexplained clinical syndromes mainly affecting children and adolescents, which are characterized by recurrent, transient, and meaningless movements or vocalizations. [Clinical manifestations] 1. Recurrent, meaningless movements or vocalizations; l Simple tic manifestations: short-lived, such as eye squeezing, head bobbing, shoulder shrugging, throat clearing, grunting, etc.; l Complex tic manifestations: longer-lived and slightly slower movements that seem to have a purpose, such as touching, dystonic postures, nasty gestures, complex vocalizations, simple statements, obscene language, etc.; l Premonitory impulses (前驱冲动)：Premonitory impulses (前驱冲) are the main cause of Tourette syndrome and Tics. premonitoryurge): appearing before the attack, temporarily relieved after the attack; 2, mostly in childhood, fluctuation in the course of the disease, focusing on attention and work can disappear, aggravated by restlessness; 3, often accompanied by Attention Deficit Hyperactivity (ADHA), executive ability disorder, obsessive-compulsive behaviors, state of mind disorders, behavioral disorders, learning ability to decline, speech disorders, and sleep disorders, and so on. Diagnosis and classification】 1. Diagnosis is mainly based on medical history 2. DSMIV classification: l Transient Tic Disorder: multiple motor or vocal tics, lasting more than 4 weeks, less than 1 year; l Chronic Tic Disorder: simple or multiple motor or vocal tics, lasting more than 1 year; l Tourette Syndrome: motor and vocal tics, with a duration of more than 1 year; l Unspecified Tics. Differential diagnosis】 1. Seizure manifestations need to be differentiated from myoclonus, chorea, epileptic seizures, dystonia, stereotyped movements, restless legs, inability to sit still, obsessive-compulsive disorder, etc.; 2. Need to be ruled out. l Huntington’s disease: genetic testing. l Neurocythematous erythrocytosis: blood smear, CK elevation, etc.. l Wilson’s disease: Kayser-Fleischer ring, blood copper blue protein, urine copper, etc.. Wilson’s disease: Kayser-Fleischer ring, blood copper blue protein, urine copper and other measurements; l Sydenham chorea: A hemolytic streptococcus test; l Pharmacological tics: stimulants, antipsychotics and so on. Indications for drug treatment: ① subjective discomfort caused by tics (pain, trauma), ② social problems (isolation, humiliation), ③ social-emotional disorders (reactive depression), or ④ dysfunction (academic impact). Commonly used drugs: 1. Alpha agonists l Clonidine: ADHD/mild-moderate tics, initial 0.05mg, therapeutic dose of 0.1-0.3mg, hypotension, drowsiness, monitoring of blood pressure and ECG; 2. Classical antipsychotics l Haloperidol: TS, from 0.25-0.5mg, maintenance 0.25-15mg, extrapyramidal system (EPS) side effects, drowsiness, increased appetite, pay attention to blood image, ECG, body weight, enzymes, neurology, prolactin; l Pimozide (Pimozide): TS, starting at 0.5-1mg, treatment 1-6mg, EPS, drowsiness, increased appetite, monitoring as above; 3, atypical nerve blockers l Aripirazole ( Aripirazole (Aripirazole): TS refractory cases, starting at 2.5mg, up to 2.5-30mg, drowsiness, inability to sit still, EPS, headache, increased appetite (milder), hypotension, monitoring of blood picture, blood pressure, body weight, ECG, liver enzymes, blood glucose; l Olanzapine (Olanzapine): TS/obsessive-compulsive behavior (OCB), starting at 2.5-5mg, up to 2.5- 20mg, drowsiness, increased appetite, inability to sit still, monitor blood picture, blood pressure, ECG, body weight, electrolytes, liver enzymes, prolactin, lipids, blood glucose; l Quetiapine: TS, starting at 100-150mg, up to 100-600mg, drowsiness, increased appetite, restlessness, hypotension, monitor as above; l Risperidone: European guidelines recommend first choice, TS/disturbed behavioral disorder (DBD), starting at 0.25mg, to 0.25-6mg, EPS, sleepiness, increased appetite, hypotension, monitoring as before; l Ziprasidone (Ziprasidone): TS, starting at 5-10mg, to 5-10mg, EPS, sleepiness, monitoring of blood picture, ECG, body weight, liver enzymes, prolactin, etc.; 4. , benzamides l Thiapride: TS, 50-100mg up to 2-10mg/kg, sleepiness, increased appetite, monitor blood picture, ECG, body weight, liver enzymes, lactogen, electrolytes.