Integrative traditional Chinese medicine for Tourette syndrome with comorbid atopic dermatitis: A one-year follow-up case report

Background: Tourette syndrome (TS) is a neurodevelopmental disorder characterized by persistent motor and vocal tics, frequently accompanied by emotional and behavioral disturbances. Allergic comorbidities such as atopic dermatitis are increasingly recognized in patients with TS, suggesting potential neuroimmune interactions. Traditional Chinese Medicine (TCM), including acupuncture and herbal medicine, has been used as a complementary treatment option, although clinical evidence remains limited.
Case Presentation: A 12-year-old boy with TS and atopic dermatitis presented with progressive motor and vocal tics since seven years of age. Symptoms included frequent eye blinking, shoulder shrugging, involuntary body movements, vocal tics, coprolalia, irritability, emotional instability, and agitation. Due to concerns regarding potential long-term adverse effects of conventional pharmacotherapy, the family opted for integrative TCM treatment. Beginning in April 2025, the patient received individualized acupuncture and herbal medicine, including Yokukansan, Gui-Zhi-Jia-Long-Gu-Mu-Li-Tang, and Tian-Ma-Gou-Teng-Yin, adjusted according to clinical response.
Results: After one year of treatment, substantial improvement was observed. The Yale Global Tic Severity Scale (YGTSS) total score decreased from 65 (severe) to 23 (mild), representing a 64.7% reduction. Motor tic scores improved from 15 to 8 (46.7% reduction), vocal tic scores from 20 to 5 (75.0% reduction), and impairment scores from 30 to 10 (66.7% reduction). Coprolalia markedly diminished and evolved into occasional simple vocal sounds. Emotional regulation, social interaction, and overall quality of life improved. Atopic dermatitis remained stable, and no treatment-related adverse events were reported.
Conclusion: This case suggests that integrative TCM may serve as a safe complementary approach for pediatric Tourette syndrome with allergic comorbidity, with clinically meaningful improvement in YGTSS scores observed over one year. Further controlled studies are warranted to validate these findings and investigate underlying neuroimmune mechanisms.