Course for Tourette syndrome in a child?

• A. Waxing and waning course in child
• B. Steadily progressive
• C. Remiss by adolescence without treatment
• D. Acute onset in adulthood

Answer: (A)

Tourette syndrome in children typically follows a fluctuating course rather than a steady decline or relentless worsening. The hallmark is tics that appear in childhood and then wax and wane in intensity over time, with periods of improvement and periods of aggravation. Some individuals may experience remission as they reach late adolescence or adulthood, but this is not guaranteed and varies widely. Onset is usually before age 18, so an acute onset in adulthood is not typical, and saying tics remit by adolescence without considering the variability isn’t accurate. The waxing and waning pattern best captures how these symptoms oftentimes evolve, reflecting the tics’ fluctuating nature and the influence of factors like stress, fatigue, and sleep on tic severity.