All new patients are evaluated by Dr. Jennifer Friedman, a movement disorder and Tourette syndrome specialist. Because this is a teaching hospital, a movement disorder fellow or UC San Diego resident physician in training may also participate in the evaluation. You may meet medical students and nurses as well.
Initial Visit
During your first visit, we will ask you and your child questions to gain as full an understanding as possible of the broad spectrum of neurological, developmental and emotional symptoms that may accompany Tourette syndrome and other tic disorders.
The physician’s assessment begins with a review of the information on the questionnaire, any other information you have brought and a detailed neurological examination. We will discuss with you diagnostic testing we recommend, if any, then review with you our recommendations for a treatment plan. This may include education about the diagnosis, discussion of how to be proactive with peers, family and the school, medical treatment, behavioral assessment or treatment through a psychologist, or referral to psychiatrists or other specialists if necessary.
Follow-up visits will be scheduled as needed to optimally manage tics.
Please bring to your visit:
- Intake Questionnaire
- Records
Outside records relevant to tic disorder or related emotional and/or learning challenges will help us to be as comprehensive as possible at your first visit. Please bring reports of any prior evaluations and investigations including imaging studies (films if available) and if applicable psycho-educational testing done at school or privately. Availability of complete records will avoid delays in diagnosis and formulation of treatment plan.In general, records from the pediatrician, family practitioner, or internist are not needed unless they specifically address the tic disorder or other neurological or psychiatric symptoms. However, if you would like us to review medical, psychological, neuropsychological or educational assessments, bring them to the visit. Brain imaging studies (CT Scans, MRI scans) and EEGs are almost never helpful in patients with tics or Tourette syndrome. However, if imaging studies have been obtained and you want us to review them, bring them to the clinic visit on a CD. - Videos
Tics may be less prominent in the examination room. If your child’s movements have not been confirmed to be tics, videotape of the movements may be helpful to the physician in order to diagnose the nature of the movement. Some children are uncomfortable being videotaped for this purpose. If you are able to video without causing discomfort, please do so. If however, your child is resistant, please discuss the need for video with the physician at the time of first visit. Our clinic staff will attempt to work with whatever format, recording and storage device that you may provide. Below find a few tips that may make your video more easily viewable.
Suggested Format: .mov or .wmv files consistently are viewable. Other formats may work but may potentially be unviewable due to compatibility issues.
Recording Device: Videos captured on digital camera are generally though not always superior to cell phone videos (depending on the quality of the cell phone video and/or camera). Either is acceptable.
Storage Device: Videos provided on flash drive are the most easily viewed in the examination room. DVD’s may need to be viewed at a separate location and/or date. Cell phone videos though acceptable are often sub-optimal because of their small size.
Follow-Up Care
Follow-up care varies depending on the needs of children and adults we evaluate. Milder cases may need education at the first visit and follow-up only as needed if symptoms worsen. Other individuals with more impairing symptoms may opt for medical or behavioral treatments at the first visit, in which case follow-up appointments will be recommended to monitor treatment benefits and possible side effects. Follow-up may also be needed to discuss results of recommended tests or referrals.