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Tic Disorder

See Also
1. Tourette's Syndrome
Epidemiology
1. Incidence of tic in children under age 10 years: 20%
2. Motor tics more common than verbal tics
Definition: Tics
1. Non-rhythmic, purposeless movements or vocalizations
2. Sudden and rapid actions
Types
1. Transient (Duration less than 12 months)
2. Chronic (Duration longer than 12 consecutive months)
  1. Primary Vocal and Motor: Tourette's Syndrome
  2. Secondary Causes of Tic Disorder
Simple Tics
1. Simple Vocal Tics
  1. Throat clearing
  2. Sniffing
  3. Animal sounds (e.g. barking)
  4. Coughing
  5. Yelling
  6. Hiccuping
  7. Belching
2. Simple Motor Tics
  1. Eye blinking
  2. Nose twitching
  3. Sticking Tongue out
  4. Head turning or neck Stretching
  5. Shoulder jerking
  6. Muscle tensing
  7. Flexing fingers
  8. Kicking
Complex Tics
1. Complex Vocal Tics
  1. Parts of words or phrases repeated
  2. Talking to oneself in multiple characters
  3. Assuming different intonations
  4. Coprolalia (Use of Profanity)
2. Complex Motor Tics
  1. Flapping arms
  2. Facial grimace
  3. Picking at clothing
  4. Complex touching movements
  5. Jumping
  6. Shaking feet
  7. Pinching
  8. Poking
  9. Kissing self or others
  10. Spitting
  11. Hair brushing
  12. Throwing motions
Differential Diagnosis
1. See Secondary Causes of Tic Disorder
2. Chorea
  1. Non-repetitive irregular movements
3. Dystonia
  1. Stereotypic, slow movements without variation
Labs
1. General
  1. Thyroid Stimulating Hormone (TSH)
2. Rapid onset varying with Upper Respiratory Infection
  1. Throat Culture
  2. Antistreptolysin O
  3. Anti-DNAse B
Management
1. Tic Management
References
1. Bagheri (1999) Am Fam Physician 59(8):2263

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This page was written by Scott Moses, MD, and was last revised 3/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.