Week 7, group D: Chronic motor disorders

1. ChronicTics&
Tourette’sDisorder

2. Signs&Symptoms
 Can range from mild to severe
 Can interfere with
communication, daily
functioning, and quality of life
 Can get worse if stressed or
anxious
 Facial Grimacing
 Excessive blinking, twitching, jerking,
coughing, throat clearing, grunting
 Shrugging
 Uncontrolled movements of legs and arms
 Bending or twisting
 Repeating observed movements
 Obscene gesturing
 Touching or smelling objects
Symptomseverity

3. What isthecause?
• The definite cause of the disorder is still unknown. Experts speculate
that it could be caused by physical and chemical abnormalities in the
brain. Nonetheless, the disorder is usually associated with contributing
factors, environmental, genetic, and sex.
• Genetics: The disorder tends to run in families with a history of
the condition thus hereditary. A genetic mutation in an
individual’s DNA is also a possible cause of motor tic disorder.
• Environmental factors: head trauma, maternal smoking,
childhood infections, pregnancy complications, low birth weight,
comorbid conditions, medication management, stress, lack of
sleep
• Sex: boys are at higher risk for tic disorders than girls

4. Ticsaretypically
diagnosedbased
onsymptoms
DIAGNOSING CHRONIC MOTOR TIC DISORDERS
 The child must meet two of the following requirements for
the child to receive a chronic motor tic disorder diagnosis:
 The tics must occur almost every day for more than a year.
 The tics must be present without a tic-free period of longer
than 3 months.
 The tics must have started before the age of 18.
 Physical assessment
 No test can diagnose the condition.
 Information is gathered about the child’s symptoms from
parents or guardian and school teacher.
 Your provider may order blood work to rule out other
conditions that might have symptoms similar to tics.
How is it diagnosed?

5. Thetreatmentapproach
 The treatment approach is contingent on
various features, consisting of the degree,
regularity, and the degree of impairment
the tics cause in daily functioning.
Coexisting conditions should also be
identified as they can influence the efficacy
of the prescribed treatment course. School,
work, and social performance should also
be assessed to determine the level of
affliction, which helps govern the
treatment plan.
3rd line treatment
Severe impairment
Typical Antipsychotics
such as Haloperidol
2nd line treatment
Severe impairment
Atypical Antipsychotics
such as Risperidone
1st line treatment
Mild impairment:
Psychotherapy focus on
behavioral modification
TreatmentOptions

6. References
Black, K. J., Black, E. R., Greene, D. J., & Schlaggar, B. L. (2016). Provisional
Tic Disorder: What to tell parents when their child first starts
ticcing. F1000Research, 5, 696. https://doi.org/10.12688/f1000research.8428.1
Black, K. J., Kim, S., Schlaggar, B. L., & Greene, D. J. (2020). The New Tics
study: A novel approach to pathophysiology and cause of tic disorders. Journal
of psychiatry and brain science, 5.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of
psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA:
Wolters Kluwer.