The Tourette syndrome clinic at Great Ormond Street Hospital (GOSH) is a multi-disciplinary clinic headed by Dr Isobel Heyman (Child and Adolescent Psychiatrist), Dr Sarah Aylett (Paediatric Neurologist) and Dr Tara Murphy (Paediatric Neuropsychologist).
The Tourette syndrome clinic is a national specialist service that cares for children and young people up to 18 years of age. We have a specialist multi-disciplinary team that works closely with other departments within GOSH, in particular neurology. The care of children is always shared between local services and the specialist service here at GOSH.
There is a strong research collaboration between GOSH and the other Tourette syndrome clinics in the UK, and we have an international reputation for clinical research into psychological treatments for Tourette syndrome, including cognitive (learning) profiles as well as studies of the genetics of tic disorders and role of infection.
What is Tourette syndrome?
Tourette syndrome is a neurological problem characterised by involuntary movements (motor tics) and sounds (vocal tics). Individuals with Tourette's syndrome may also have emotional and behavioural problems such as obsessive compulsive disorder, attention deficit hyperactivity disorder, difficult behaviour or learning problems.
What is the Tourette syndrome clinic?
The GOSH clinic is a national specialist clinic for young people with Tourette syndrome. We see children and adolescents from all over the country.
It is a tertiary level clinic, which means that written referrals usually come from the consultant pediatrician or child and adolescent psychiatrist already looking after a child in their own area. We do not take-over the care of children referred to us, but work in partnership with the referring doctor.
Who do we see and what do we offer?
we see young people up to age 18
we assess young people with suspected Tourette syndrome, where the diagnosis is in doubt or is complex
we assess young people with problematic Tourette syndrome, eg with associated mental health problems or troublesome tics, and advise on management
- we offer flexible packages of management, individually tailored ot the needs of the child and family
- we use evidence-based treatments (ones that have been established to be effective)
we give advice on medication and psychological treatment
we can provide monitoring/prescribing of medication in conjunction with local services
we can offer short packages of psychological treatment
where appropriate we offer neuropsychological assessment
we have programmes of child and parent groups
What happens if you come to clinic?
We adhere to national guidelines for maximum wait times, but try to see patients as quickly as possible, taking clinical urgency into account.
The team will try to advise the referrer on the telephone if possible. If the appointment we offer is inconvenient, please let us know as soon as possible and we will arrange an alternative.
Before the appointment we will ask the family, child and school to fill in some questionnaires, which help us make the best use of time in the clinic. The young person and family will first meet one of the junior doctors, who will take a detailed account of the problems, and the family will then meet with one of the consultants. There may also be input from the clinical psychologist. Feedback is given on the day, and a written report will be sent to the referrer and the family.
Please allow 2-3 hours at the clinic for new patients.
Who else can help with Tourette syndrome?
Most people with Tourette syndrome can be successfully helped by their local paediatrician or child psychiatrist. Most child specialists will know about the medications that are sometime used in Tourette syndrome, and the sort of help that children with Tourette syndrome may need psychologically or at school.
We are always happy to try to advise doctors on the telephone.