Tic DIsorders Flashcards
A sudden, rapid, recurrent, non-rhythmic, stereotyped motor movement or vocalization causing distress or significant impairment often involuntary or response to irresistible urge
Tic
Tic disorders have onsets before the age of
18 years old
Sudden, brief, stereotypic, repetitive movements
-Eye blinks, grimacing, jaw snaps, lip pouts, tensing or rapid jerking of a body part such as the arm, head or neck
Simple Motor Tics
Often slower than simple tics, or an orchestrated series of what appear as more purposeful, longer movements
Complex motor tics
What are three examples of complex motor tics?
Echopraxia, Copraxia, anbd Self-injurious
Imitating movements or gestures of other people
Echopraxia
Obscene, aggressive or otherwise inappropriate gestures, e.g., Giving the finger
Copraxia
Often occur at points of initiation or transition in speech
Vocal Tics
Meaningless, sounds such as
• Throat clearing, coughing,
• Spitting,
• Screeching, barking, grunting, whistling, hissing
Simple vocal tics
Syllable sounds such as “uh, uh”, “eee”, and “bu”
Simple Vocal Tic
Meaningful utterances of words or phrases
• “Oh boy”, “you know”, “shut up”. “you’re fat”, “what’s that?”
Complex vocal tics
What are three types of complex vocal tics?
- ) Echolalia
- ) Palilalia
- ) Coprolalia
Repeating others words
Echolalia
Repeating ones own words
Palilalia
Obscene, aggressive or otherwise socially unacceptable words or phrases
-Often explosive
Coprolalia
The most socially impairing complex symptom
Coprolalia
Multiple motor and 1 or more vocal tics present some time during the illness
-Wax and Wane; not necessarily concurrent
Tourette’s DIsorder
Single or multiple motor or vocal tics present some time during the illness, but never both
Persistent (chronic) Motor or Vocal Tic DIsorder
Similar to Tourette’s, but the Tourette’s disorder criteria never met
Persistent (chronic) Motor or Vocal Tic disorder
What are two other examples of DSM-5 Tic disorders?
Provisional Tic disorder and Other specified tic disorder
Single or multiple motor or vocal tics present some time during the illness
-BUT, Tics present for LESS than 1 year since tic onset
Provisional Tic disorder
What percentage of children experience a Tic as a transient phenomenon?
20%
How many children per 1000 school aged children have Tourette’s?
308/1000
Prevalence of all tics (chronic or transient) estimates range from:
- ) For boys
- ) For girls
- ) 6% to 18%
2. ) 3% to 11%
Generally the male to female ratio of Tic disorders is
Greater than or equal to 2:1
Relatives of those with TD at markedly increased risk for
Tic Disorders
Monozygotic twins have concordance of 7794% for
Chronic Tic disorders
Dizygotic twins 23% concordance for
Chronic Tic Disorders
Antecedent sensory feeling (e.g., itch to scratch)
- Often irresistible
- Sometimes painful or source of mental impairment
Tic
What percentage of people with Tics have coprolalia?
10%
Usually quick, jerking movements or repetitive sounds that are difficult to control
Tic
Tics usually decrease in intensity through adolescence and may be gone in adulthood with
Tourette’s
Tic anatomic location, frequency, and severity can and usually do change over time with
Tourette’s
The severity of Tourette’s is worse between
9-12 years
With Tourette’s, the trunk and legs typically don’t display tics until after
6 years of age
Group A Beta-hemolytic streptococcus (GABHS) preceded tics in
44% of Children with symptoms
This streptococcal induced tic disorder is called
PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associates w/ Streptococcal Infection)
A study showed that with increasing age, patients with Tourette’s Syndrome had a lag to deactivate
Prefrontal and cingulate cortex
Some tics are increased by the inability of basal ganglia to suppress motor neural areas that initiate
Tics
Another factor impacting Tic symptom severity is abnormal
Dopamine modultion
Patients with Tourette’s syndrome that do not have a comorbid disorder have
higher IQ and fewer learning disabilities
May be idiopathic or result from a variety of medications or general medical conditions
Tics
Should be differentiated from a variety of developmental and benign movement disorders
Tics
Two forms of treatment for TIC disorders that do not require medicine are
Habit reversal training and Cognitive Behavioral Therapy
