MBBS OSCE · Psychiatry
OSCE — Tourette Syndrome & Tic Disorders
Eight-minute OSCE station on Tourette Syndrome & Tic Disorders: focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Tourette Syndrome & Tic Disorders.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Tourette syndrome (TS) is a neurodevelopmental disorder defined by multiple motor tics and one or more vocal (phonic) tics, present for at least 1 year, with onset before age 18. Tics are sudden, rapid, recurrent, non-rhythmic movements or vocalisations that are temporarily suppressible and usually preceded by a premonitory urge (a building internal sensation that the tic transiently relieves). Motor tics classically begin in the head and neck (eye blinking, facial grimacing, head jerking, shoulder shrugging) and march caudally over years; vocal tics follow (throat clearing, sniffing, grunting; coprolalia in only 8 to 15 percent). Tics wax and wane, peak in severity around 10 to 12 years, an
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Multiple motor plus vocal tics for over 1 year, onset before 18 - Tourette syndr |
| Safety | Sudden explosive onset of tics in a child over 24 to 72 hours - consider PANDAS |
| Safety | Severe continuous tics causing exhaustion, self-injury, rhabdomyolysis or airway |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.