Tic disorder
- 1. TIC DISORDER
- 2. TIC DISORDERTICS- RAPID AND REPETITIVE MUSCLE CONTRACTIONS RESULTING IN MOVEMENTS OR VOCALIZATIONS WHICH ARE INVOLUNTARY TYPES:SIMPLE MOTOR TICS- FUNCTIONALLY SIMILARMUSCLE GROUPSEYE BLINKING, SHRUGGING OF SHOULDER, NECK JERKINGSIMPLE VOCAL TIC- COUGHING,THROAT CLEARING, GRUNTING, SNIFFINGCOMPLEX MOTOR TICS- SMELLING OF OBJECTS, GROOMING BEHAVIOR, ECHOPRAXIA, COPROPRAXIACOMPLEX VOCAL TICS- REPEATING WORDS AND PHRASES OUT OF CONTEXT (COPROLALIA, ECHOLALIA)WAX AND WANE DECREASED BY SLEEP, RELAXATION OR ABSORPTION IN AN ACTIVITY
- 3. TOURETTE’S DISORDERDIAGNOSTIC CRITERIAA. BOTH MULTIPLE MOTOR AND ONE OR MORE VOCAL TICS HAVE BEEN PRESENT AT SOMETIME DURING THE ILLNESS, ALTHOUGH NOT NECESSARILY CONCURRENTLYB. THE TICS OCCUR MANY TIMES A DAY (USUALLY IN BOUTS) nearly everyday or intermittently throughout a period of more than one year AND DURING THIS PERIOD THERE WAS NEVER A TIC FREE PERIOD OF MORE THAN 3 CONSECUTIVE MONTHSC. THE ONSET IS before 18 years of ageD. the disturbance is not due to direct physiological effects of a drug or a general medical condition
- 4. Tourette’s DisorderLifetime prevalence 4 to 5 per 10,0005 to 30 children per 10,000 onset of motor component by age 7 vocal tics by 11 years3 males: 1 femaleFamilial illnessAssociation with ADHD and OCD? Dopamine, endogenous opiods
- 5. Tourette’s Disorder? Post streptococcal syndromeCLINICAL FEATURESTics may occur as early as 2 yearsInitial tics in the face and neck progress downwardMost frequent initial symptom eye blink tic, followed by head tic and facial grimace
- 6. Tourette’s DisorderPRODROME: IRRITABILITY, ATTENTION DIFFICULTIES, POOR FRUSTRATION TOLERANCEOBSESSIVE COMPULSIVE SYMTOMS OCCUR AFTER ONSETCOPROLALIA IN 1/3 OF CASESNO SPECIFIC LABORATORY OR DIAGNOSTIC TESTTREATMENT - HALOPERIDOL
- 7. DIFFERENTIAL DIAGNOSIS1.CHRONIC MOTOR OR VOCAL TIC DISORDERA. SINGLE OR MULTIPLE MOTOR OR VOCAL TICS BUT NOT BOTH, HAVE BEEN PRESENT AT SOMETIME DURING THE ILLNESSB. TICS OCCUR MANY TIMES A DAY NEARLY EVERYDAY OR INTERMITTENTLY THROUGHOUT A PERIOD OF MORE THAN O9NE YEAR AND DURING THIS PERIOD THERE WAS NEVER A TIC FREE PERIOD OF MORE THAN 3 CONSECUTIVE MONTHSC. THE ONSET IS BEFRORE 18 YEARSD. THE DISORDER IS NOT DUE TO THE PHYSIOLOGICAL EFFECTS OF A SUBSTANCEE. A CRITERIA HAVE NEVER BEEN MET FOR TOURETTE’S DISORDER
- 8. DIFFERENTIAL DIAGNOSISTRANSIENT TIC DISORDERA. SINGLE OR MULTIPLE MOTOR AND OR VOCAL TICSB. THE TICS OCCUR MANY TIMES A DAY NEARLY EVERYDAY FOR AT LEAST 4 WEEKS BUT FOR NO LONGER THAN 12 CONSECUTIVE MONTHSC. ONSET BEFORE 18 YEARSD AND E (SIMILAR TO CHRONIC MOTOR TIC)DO NOT DEVELOP TO A MORE SERIOUS TIC DISORDER,MAY APPEAR DURING STRESS