Tourette Syndrome
Patient Education

Allergy Testing

Exposure to allergen may cause sniffing, blinking or tic-like behavior

A pad containing the allergen solution is taped to the skin for 24-72 hours. A raised area of skin with redness and itch denotes an allergic reaction.

The test may be done by having a drop of solution with the allergen placed on the skin with scratches or needle pricks. If a raised, red and itchy area of the skin develops (wheal), an allergy is diagnosed to that allergen. (Positive reaction)

No reaction to allergens detected

MRI

(Magnetic resonance imaging)

Looking for brain injury, structural abnormality or infection within the brain

You are asked to lie on your back on a table with head, torso and arms strapped down to prevent movement. The table then slides into the tunnel-like space that contains a magnet.

You may hear banging or tapping noises from the magnet movement but are often offered piped in music to soothe you and mask the noise.

Images are taken in body cross sections.

The test usually takes 30-60 minutes and is painless

No unusual break in brain integrity or cerebral vessels

Blood Tests

To rule out Wilson’s Disease

After a tourniquet is applied to the upper arm, the puncture site of skin is swabbed with alcohol pads and a needle punctures the skin. Blood is then drawn into a syringe for analysis.

The needle is removed and a pressure bandage is applied to the puncture site.

Ceruloplasmin
20–50 mg/dL
Total serum copper
80- 163 mcg/dl

Comprehensive Metabolic Panel:
Albumin
0-3yr=2.9-5.5
3y-adult=3.5-5

Alkaline phosphatase
1dy-15yr=80-250units/L
15 yr-adult=30-125 units/L

SGPT=0-40
SGOT= 3-44

Bilirubin
1d-1mo=.6-11.1mg/dL
1mo-adult=.2-1.3 mg/dL

Calcium
1dy-1mo=7.3-11.9 mg/dL
1mo-adult=8.7-10.7mg/dL

Carbon dioxide
1dy-1y=13-22
1yr-15 yr= 20-28 mmol/L
15yr-adult=22-29 mmol/L

Chloride
1dy-1yr=13-22
1y-15y=20-28
15y-adult=22-29

Glucose
Fasting=60-99 mg/dL
Nonfasting=60-200

Potassium
1dy-1mo=4-6.0 mmol/L
1mo-adult=3.4-5.3 mmol/L

Protein,total
1dy-1mo=5.3-8.9g/dL
1mo-8yr=5.6-8.5 g/dL
8yr-adult=6-8.2

Sodium=137-147 mmol/L

Urea Nitrogen (BUN)
1dy-1mo=4-12 mg/dL
1mo-15 yr=5-18 mg/dL
15 yr-adult=8-21

Strep Culture

Blood Test for Streptococcus

Rule out PANDAS disorder (Pediatric Acute-Onset Neuropsychiatric Syndrome)

Blood test (twice with an interval) is done to look for anti-streptococcal antibody titers

Swab is taken on the mouth and throat and placed on laboratory petri dish for analysis

After a tourniquet is applied to the upper arm, the puncture site of skin is swabbed with alcohol pads and a needle punctures the skin. Blood is then drawn into a syringe for analysis.

The needle is removed and a pressure bandage is applied to the puncture site.

Culture is negative for Strep.

Titers are negative for anti-streptococcal antibodies

PET Scan

(Positron Emission Tomography)

Measures the activity of a mass, lump or node

Used for staging of disease or response to treatment

Distinguishes between lumps and scar tissue

You will lie on an examination table and an IV may be inserted into a vein in your arm or hand.

A radiotracer may be introduced into your body through the IV or you may be asked to swallow or inhale the substance.

After one hour, you may drink a liquid containing contrast material. A CT scan will be performed followed by going into a PET scanner where imaging is performed. The test will take 30 minutes to 3 hours depending on the extent of tissue or organs to be evaluated.

While the technician checks the images, you must remain on the table because additional images may need to be taken.

Once satisfactory, the IV is removed and you may rise from the examining table.

No tumors, masses or enlarged lymph nodes.

No increased activity in organs, vessels and lymph nodes

CT Scan

(Computed tomography)

Used to detect enlargement or abnormalities of organs, blood vessels, lymph nodes and soft tissue of the body

You will be asked to lie on a narrow examination table. An intravenous needle and line may be inserted. You may be asked to swallow contrast material, which may be slightly unpleasant

Restraints may or may not be used to maintain a still position.

The table then slides into the center of a “tunnel-like” machine. The X-ray tube rotates around you and you may hear banging as imaging takes place.

A speaker and microphone may be fixed into the chamber allowing you to talk and hear the technician as well as hearing piped in music.

When satisfactory images are obtained, the table will slide out of the chamber and you may arise from the table.

Normal sized organs, blood vessels and lymph nodes with no enlargements, distortions or abnormal shapes or narrowing.