Host: Well, I guess we are hearing something about I think called Tourette syndrome. What is Tourette syndrome? Guest: Tourette is a compulsive motor movement, a tic, typically will present as a blink and if one also has a compulsive voice like a grunt or a squeaky voice or some people think snoring, that would be a compulsive voice. And if you have both of those for years it's called Tourette. Host: But the trick is it has to be there for? Guest: A whole year. Now, a key thing to know about Tourette, this too is genetic. That is very common. It's much more common than anybody knows. The other key thing to know is that most children that have Tourette, a lot of them outgrow it and most children really aren't terribly affected by it. In other words, they do very well and go on and become president of companies and what have you. And the great majority of children do not need treatment for Tourette. There are medications for it, but the great majority do not need to be on medication for Tourette. Children with Tourette do not need tests; they need to be looked at in terms of associated problems because patients with Tourette's are more likely to have ADHD, obsessive compulsive disorders, learning disabilities in depression, but they need not to have those things. Host: Are there any medications if you do have Tourette's that's obviously affecting the way it functions at all? Guest: Yes, there are medications that can diminish the tics. Now tics just like ADHD in my estimation should not be treated unless they affect the child academically, socially, or sometimes tics actually hurt physically, because you are blinking so much, it hurts your eyes. In those situations one can consider medications and the typical first-line medication with probably the best safety profile is Clonidine or Catapres which is a blood pressure medication. After that people sometimes use major tranquilizers which have a little bit of a worse safety profile, but again, I want o stress that most people with tics or Tourette's have a relatively easy course and it doesn't affect their life terribly much. This is one of those situations that one has to be very careful about what's on the Internet. For example, there is a lot of information on the Internet about Tourette's and it's all very good information. There is a Tourette's Association, it's a wonderful organization. But if you read what they have to say, they are talking about the 1% of patients that are very severely impaired and parents very often will go right to that and say, oh my goodness, my child has this horrible disorder and the reality is, most patients that have Tourette's have a very mild course and don't even need medication and do perfectly well in life and very often outgrow it. Host: There is a condition what they call benign habit tic, what is that? Guest: I am not sure what that is. A benign tic is just a tic and if you have a tic without voices, without noises for a year, we call it a tic disorder. Again, there is a real overlap between Tourette and tic disorder, I personally think they are the same but we don't know, because we haven't found, again, not I; it's not my research interest, but no one has found a gene for a Tourette or tic disorder, maybe the same. Host: Some kids get blinking, they are in school under little bit of stress and it goes away, that's not related to this, is it? Guest: Well, that's a tic and it's probably part of the spectrum and I think a lot of us and I think I sometimes blink too much too and that may as well be a tic and that's why one can't get too terribly worried about this stuff. Host: Thank you!