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tic disorder

Etiology: - comorbidities are common - attention deficit hyperactivity disorder - obsessive-compulsive disorder - anxiety - autism [3] - Tourette syndrome - cerebral palsy - Huntington's disease [3] - idiopathic Genetics: - may be family history Clinical manifestations: - a local & habitual twitching (repetitive tic), especially in the face - phonic tic such as cough - complex tics such as finger tapping - tics are suppressible (at least temporarily) [3] - may provide transient relief of uncomfortable senstations [3] Differential diagnosis: - compulsion - Tourette syndrome Management: - treat comorbidities - no intervention indicated unless social, occupational, or scholastic function is impaired [2] - cognitive behavioral therapy first line treatment [6] - centrally-acting alpha-agonist first line pharmaceutical - clonidine - dopamine receptor antagonist for disabling or disruptive tics - pimozide - haloperidol [3] - more effective than clonidine but reserved for second line therapy due to risk of tardive dyskinesia [3] - guanfacine ineffective [5] - deep brain stimulation in severe cases [6]

Related

repetitive tic

Specific

Gilles de la Tourette's syndrome

General

movement disorder

References

  1. The free dictionary http://freedictionary.org
  2. Tic disorder. From Wikipedia, the free encyclopedia http://en.wikipedia.org/wiki/Tic_disorder
  3. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018 2021.
  4. Jankovic J. Differential diagnosis and etiology of tics. Adv Neurol. 2001;85:15-29. PMID: 11530424
  5. Murphy TK et al. Extended-release guanfacine does not show a large effect on tic severity in children with chronic tic disorders. J Child Adolesc Psychopharmacol 2017 Jul 19 PMID: 28723227
  6. Pringsheim T, Okun MS, Muller-Vahl K et al Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. May 07, 2019; 92 (19) Special Article PMID: 31061208 https://n.neurology.org/content/92/19/896 - Pringsheim T, Holler-Managan Y, Okun MS et al May 07, 2019; 92 (19) Special Article Comprehensive systematic review summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology. May 07, 2019; 92 (19) Special Article PMID: 31061209 https://n.neurology.org/content/92/19/907