Tic disorder

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Tic disorder

  1. 1. TIC DISORDER<br />
  2. 2. TIC DISORDER<br />TICS- RAPID AND REPETITIVE MUSCLE CONTRACTIONS RESULTING IN MOVEMENTS OR VOCALIZATIONS WHICH ARE INVOLUNTARY <br />TYPES:<br />SIMPLE MOTOR TICS- FUNCTIONALLY SIMILAR<br />MUSCLE GROUPS<br />EYE BLINKING, SHRUGGING OF SHOULDER, NECK JERKING<br />SIMPLE VOCAL TIC- COUGHING,THROAT CLEARING, GRUNTING, SNIFFING<br />COMPLEX MOTOR TICS- SMELLING OF OBJECTS, GROOMING BEHAVIOR, ECHOPRAXIA, COPROPRAXIA<br />COMPLEX VOCAL TICS- REPEATING WORDS AND PHRASES OUT OF CONTEXT (COPROLALIA, ECHOLALIA)<br />WAX AND WANE DECREASED BY SLEEP, RELAXATION OR ABSORPTION IN AN ACTIVITY <br />
  3. 3. TOURETTE’S DISORDER<br />DIAGNOSTIC CRITERIA<br />A. BOTH MULTIPLE MOTOR AND ONE OR MORE VOCAL TICS HAVE BEEN PRESENT AT SOMETIME DURING THE ILLNESS, ALTHOUGH NOT NECESSARILY CONCURRENTLY<br />B. 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 MONTHS<br />C. THE ONSET IS before 18 years of age<br />D. the disturbance is not due to direct physiological effects of a drug or a general medical condition <br />
  4. 4. Tourette’s Disorder<br />Lifetime prevalence 4 to 5 per 10,000<br />5 to 30 children per 10,000 <br />onset of motor component by age 7 vocal tics by 11 years<br />3 males: 1 female<br />Familial illness<br />Association with ADHD and OCD<br />? Dopamine, endogenous opiods<br />
  5. 5. Tourette’s Disorder<br />? Post streptococcal syndrome<br />CLINICAL FEATURES<br />Tics may occur as early as 2 years<br />Initial tics in the face and neck progress downward<br />Most frequent initial symptom eye blink tic, followed by head tic and facial grimace<br />
  6. 6. Tourette’s Disorder<br />PRODROME: IRRITABILITY, ATTENTION DIFFICULTIES, POOR FRUSTRATION TOLERANCE<br />OBSESSIVE COMPULSIVE SYMTOMS OCCUR AFTER ONSET<br />COPROLALIA IN 1/3 OF CASES<br />NO SPECIFIC LABORATORY OR DIAGNOSTIC TEST<br />TREATMENT - HALOPERIDOL<br />
  7. 7. DIFFERENTIAL DIAGNOSIS<br />1.CHRONIC MOTOR OR VOCAL TIC DISORDER<br />A. SINGLE OR MULTIPLE MOTOR OR VOCAL TICS BUT NOT BOTH, HAVE BEEN PRESENT AT SOMETIME DURING THE ILLNESS<br />B. 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 MONTHS<br />C. THE ONSET IS BEFRORE 18 YEARS<br />D. THE DISORDER IS NOT DUE TO THE PHYSIOLOGICAL EFFECTS OF A SUBSTANCE<br />E. A CRITERIA HAVE NEVER BEEN MET FOR TOURETTE’S DISORDER <br />
  8. 8. DIFFERENTIAL DIAGNOSIS<br />TRANSIENT TIC DISORDER<br />A. SINGLE OR MULTIPLE MOTOR AND OR VOCAL TICS<br />B. THE TICS OCCUR MANY TIMES A DAY NEARLY EVERYDAY FOR AT LEAST 4 WEEKS BUT FOR NO LONGER THAN 12 CONSECUTIVE MONTHS<br />C. ONSET BEFORE 18 YEARS<br />D AND E (SIMILAR TO CHRONIC MOTOR TIC)<br />DO NOT DEVELOP TO A MORE SERIOUS TIC DISORDER,MAY APPEAR DURING STRESS<br />

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