TIC DISORDER

Question 1

What is the structure of Hx

Answer 1

ONSET, DURATION, PROGRESS, IMPACT

Description of the problem behaviour from parents and teachers

• Type of tics (Motor, vocal or both)
• The setting of manifestation of the tics
• The effect on others [siblings, family, friends, teachers]
• Also enquire about other current problems or complaints

Question 2

What other things to look for in Tics Hx

Answer 2

• Conditions ADHD, OCD, Conduct Disorders

Anxiety Depression

• Look for family h/o tics, OCD, anxiety disorders, depression

AUTISM, Intellectual Disability Disorder

.
• Explore the medical history and history of infective illness

Question 3

What is the treatment for TICS

Answer 3

Psychological

1. Advice for parents to ignore tics 
and commenting on them makes 
no difference and may affect the child's self-esteem 
2. Education about the condition.
Liaise with the schools, ‘Tic 
Breaks at  school
3. Groups with affected young persons
4. Reduction of external stressors.
Parental  support: Families may require support and education to understand the condition

Question 4

What is the pharmacological treatment for tics

Answer 4

Mild forms no treatment
Low dose Haloperidol and Risperidone
If tics are disabling and unresponsive to other therapies

Can also try Sulpiride and Clonidine

Question 5

Aside from pharmacological treatment what else

Answer 5

Treat the co conditions like
OCD, ADHD

This may be clinically more important than the treatment of the
core features of the syndrome

Question 6

What are the Associated Cormobid Conditions

Answer 6

1. ADHD, Hyperactivity and behavioural problems (25 to 50%)
2. OCD (30 to 60%)
3. Behavioural problems
4. Emotional disorders such as anxiety and depression

Question 7

What is the prognosis

Answer 7

Many last few weeks
Others are longer
80 to 90% of cases improve within 5 years.
A few become chronic and even life long