Your initial visit allows us 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. Results of previous treatments, if any, are also very important. For this reason, we appreciate your filling out the intake questionnaire. It is most efficient if you can fill this out before the visit. To receive a copy prior to your scheduled visit, contact us at firstname.lastname@example.org. You may feel free to email it back to us at this HIPAA secure email.
Records may also help. 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.
Sometimes tics and other movements are best seen on home videos. You may feel free to bring these videos to clinic for our review as this can be extremely helpful. Contact us if you want to send them digitally.
All new patients are evaluated by a Movement Disorder and Tourette Syndrome specialist physician in clinic, generally Donald Gilbert or Steve Wu. Because this is a teaching hospital, a movement disorder fellow, who has completed at least five years training in Pediatrics and Neurology, or a Cincinnati Children’s or University of Cincinnati resident physician in training, may also participate in the evaluation. You may meet medical students. You will also meet nurses or our nurse practitioner at your first visit.
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 care by the Tourette Syndrome and Tic Disorder Clinic 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. Our certified nurse practitioner, Tara Lipps, oversees many follow-up visits, and she is available for urgent follow-up visits. Lipps has worked with Gilbert since 2000 and has evaluated hundreds of patients with Tourette syndrome. She has received subspecialist training through the Tourette Syndrome Association USA, has co-authored a published review on Tourette syndrome treatment options and is certified in Ohio and Kentucky to evaluate follow-up visits independently. All diagnostic and therapeutic decisions in our practice are reviewed as a team with Gilbert and Wu.