The prognosis of hyperactivity disorder (also known as Tourette’s syndrome, or TS), whether the disorder can be completely cured, how it will affect the future growth and development of the child, and whether it will cause disability are the main concerns of many parents. Before the 1970s, TS was considered a lifelong disease, but in the 1970s, the antipsychotic drug haloperidol was found to be effective in treating TS. In recent years, it has been found that most patients with TS have significant improvement or even complete disappearance of tic symptoms by the time they reach adolescence, but because the etiology is not yet clear, treatment is mainly symptom control and requires prolonged maintenance with medication. In addition, some patients with TS are more difficult to treat and suffer from prolonged symptoms. Qian Lianhua et al. concluded that the majority of patients with TS had a good outcome at 9-12 years of follow-up, but a small percentage of patients had obsessive-compulsive disorder, conduct disorder, and tic symptoms that affected their quality of life. The results of a 6-12 year follow-up study of 65 patients with TS by Wang Jian showed that the rate of improvement in the disappearance of symptoms was 91%, and suggested that the duration of TS, the presence of other psychiatric disorders, family history of neuropsychiatric disorders and past history may affect the prognosis of TS. The following factors affect the prognosis of TS: 1. Relationship between diagnosis and prognosis: The correct diagnosis has a close relationship with the treatment effect and prognosis. The symptoms of involuntary movements are more common in childhood, and the causes are complex and varied, so they need to be identified. Several subtypes of tic disorders have their own natural course, and there are limits to the duration and remission of the disorder according to their diagnostic criteria, e.g., TS starts before the age of 18, symptoms can continue into adulthood, and brief remission of tic symptoms usually does not exceed 2 months. In a study by Bruun et al. on the relationship between prognosis and disease spectrum in TS, 58 patients with tic disorders were followed for 2 to 14 years and 10 were still diagnosed with tic disorders, 23 with chronic motor and vocal tics, and 25 with TS. The prognosis of TS is related to age factors: The upper limit of the age of onset of TS varies among different diagnostic criteria, such as DSM-IV and CCMD-3 before 18 years of age, and ICD-10 before 21 years of age. Some patients with juvenile onset may have complete symptom onset over the next 10 years, but sometimes symptoms change significantly on a daily or weekly basis, and in some cases symptoms begin to improve only in late adolescence and early adulthood. About 1 in 3 patients have complete resolution of tic symptoms, and the remaining 2 in 3 patients have improved and less severe symptoms that do not cause damage, but may occasionally recur throughout life. Very few older adults are diagnosed with TS, and no more than 1% of all patients over 65 years of age. In addition, it has been suggested that children with TS starting between 4 and 6 years of age have a poorer prognosis. It is thought that the severity of tics in childhood is not yet a predictor of their later course. It is also believed that about 2/3 of children with TS can predict improvement or almost complete disappearance of symptoms. The relationship between TS comorbidity and prognosis: In addition to tic symptoms, the most common comorbidities of TS include attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), conduct disorder, learning difficulties, mood disorders, and self-injurious behavior, which increase the complexity and severity of TS and make treatment more difficult and affect the social functioning and rehabilitation of the child to varying degrees. ADHD may be more damaging than TS symptoms and may lead to delinquency and a poorer prognosis for children with aggressive behavior, moral problems, or other delinquent behaviors. For children with TS combined with ADHD, the prognosis is even worse if they are not properly handled by school and parents, discriminated against, reprimanded, scolded or suspended from school, which may intensify the conflict between the child and the school parents, resulting in emotional resistance and defiance. The pathophysiological mechanisms underlying the relationship between TS and ADHD are not yet clear. There are conflicting views on the relationship between TS and psychostimulants. It has been suggested that methylphenidate may induce or exacerbate tic symptoms. Recent double-blind controlled studies have concluded that regular doses of methylphenidate are equally effective in treating ADHD with TS, and that most patients do not experience worsening of TS symptoms. However, the treatment process needs to be closely monitored and carefully selected. The combination of haloperidol or perphenazine with psychostimulants is generally effective in treating ADHD with TS, and colistin hydrochloride may also be used. The incidence of TS with OCD is 30%-50%, and there may be a genetic relationship between the two. OCD is usually more persistent than tic symptoms, causing severe disruptions in daily activities and learning, suggesting that OCD is an important factor in the long-term prognosis of TS patients, and therefore often requires psychiatric hospitalization. These children are usually poorly treated with anti-OCD drugs alone, and most of them have improved symptoms when combined with 5-HT recycling inhibitors (SSRIs) and nerve blockers. The impact of mood disorders, behavioral and learning problems on the prognosis of TS: Patients with TS often have mood disorders, such as anxiety, over-sensitivity, nervousness and fear; or depression, agitation, temper tantrums, impulsivity, aggression, etc., which may cause the main symptoms of TS to be more serious, affecting the recovery of the disease and the ability to adapt to society, making it difficult for parents and teachers to discipline the child, and often serious learning problems. This often leads to serious learning problems. In addition to specific learning deficits, some children with TS also have tic symptoms, especially vocal tics, that interfere with classroom learning and order, and are subject to ridicule and discrimination, resulting in reluctance to attend or drop out of school. The prognosis of TS may be affected by poor family environment and education, as well as psychosocial developmental deficits during the early years. Therefore, children with TS should be raised and educated in a proper way to cultivate a good and sound character and behavior, and children with TS are susceptible to psychiatric factors, so timely control of tics and accompanying behavioral symptoms is needed to reduce physical discomfort and psychological distress, and to improve the child’s bad behavior and mood, which is important for the prognosis of TS and the prevention of psychotic symptoms. The impact of medication on prognosis: Generally, most of the symptoms of children with TS can be improved or completely relieved with appropriate medication, such as haloperidol, Tebretol, and permethrin, but they need to take medication continuously for 1 to 2 years. Lack of compliance with medication by parents and children, premature discontinuation, inappropriate dosage, or too frequent changes in medication may cause relapse or worsening of symptoms; sudden discontinuation of medication may also lead to withdrawal symptoms and affect prognosis. However, some children with TS may suffer from side effects of medication that may affect their learning or daily activities, such as drowsiness, unresponsiveness, memory loss, depressed mood, difficulty in writing and operation, decreased performance, and aversion to school. According to the results of a study by Zhisheng Liu et al. on memory function and memory pattern deficits in hyperactivity disorder, it is suggested that drugs such as haloperidol have an effect on the total memory function of children with TS. Therefore, the prognostic follow-up process of children with TS still needs to pay attention to the negative pharmacogenic effects. The behavioral symptoms of children with TS require a detailed understanding of the condition and diagnostic evaluation in order to distinguish between primary and secondary problems and causality, and to provide psychological intervention and pharmacological treatment. While controlling the symptoms of TS, appropriate measures should be taken to improve the behavioral symptoms. For example, if TS is combined with OCD, haloperidol combined with 5-HT recycle inhibitor treatment is more effective and beneficial to recovery. In addition, if the self-injurious behavior of TS is serious, there is a risk of disability or even death, so timely control is needed to avoid adverse prognostic effects. For example, the application of permethrin has a significant effect on the control of twitching and self-injurious behavior. 5, other factors on the prognosis: TS children in the treatment process, symptoms may often relapse or fluctuate after remission due to endogenous or exogenous influences, and the symptoms may be mild or severe to affect the prognosis, usually related to the following factors: menstruation and other endocrine changes, physical illness, fever infection (especially viral infection), smoking, alcohol and beverages (such as coffee), trauma accidents, cold and hot climate, trauma, overexcitement or fatigue, excessive study load, mental stress during the exam period, living away from home, and taking medications (antipsychotics, antidepressants, psychostimulants, antiepileptics, antihistamines, cocaine, levodopa, etc. can trigger or exacerbate TS). Therefore, the influence of certain triggering or exacerbating factors should be considered for those who develop significant symptoms during the recovery period of TS. In conclusion, most children with TS have a good prognosis, but there are some refractory cases, especially those with behavioral symptoms and psychiatric disorders, which are still difficult to treat. For this reason, further research on the etiology of TS is needed to find safe and effective pharmacological treatment and psychological interventions, as well as to disseminate scientific knowledge about TS and enhance prevention efforts to protect the physical and mental health of children.