Tic disorder

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Tic disorder
Examples of tics
Specialty Neurology, psychiatry

Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements). [1] Tic disorders are defined similarly by the World Health Organization (ICD-10 codes). [2]

Contents

Classification

DSM-5

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in May 2013, classifies Tourette syndrome and tic disorders as motor disorders listed in the neurodevelopmental disorder category. [3]

Tic disorders, in ascending order of severity, are: [3]

Developmental coordination disorder and stereotypic movement disorder are also classified as motor disorders. [4] [5]

ICD-10

ICD10 diagnosis codes are: [6]

Diagnosis

Tics should be distinguished from other causes of tourettism, stereotypies, chorea, dyskinesias, myoclonus and obsessive-compulsive disorder. [3]

Treatment

Education, and a "watch and wait" strategy, are the only treatment needed for many, and the majority of individuals with tics do not seek treatment. When needed, management of tic disorders is similar to management of Tourette syndrome. [7]

Epidemiology

Tic disorders are more commonly diagnosed in males than females. [3]

At least one in five children experience some form of tic disorder, most frequently between the ages of seven and twelve. [8] [9] As many as 1 in 100 people may experience some form of tic disorder, usually before the onset of puberty. [9] Tourette syndrome is the more severe expression of a spectrum of tic disorders, which are thought to be due to the same genetic vulnerability. Nevertheless, most cases of Tourette syndrome are not severe. Although a significant amount of investigative work indicates genetic linkage of the various tic disorders, further study is needed to confirm the relationship. [10]

History

DSM-IV-TR

In the fourth revision of the DSM (DSM-IV-TR), tic disorders were classified as follows: [11]

From DSM-IV-TR to DSM-5

DSM-5 was published in 2013, updating DSM-IV-TR, which was published in 2000. The following changes were made: [3] [12] [13] [4]

Related Research Articles

<i>Diagnostic and Statistical Manual of Mental Disorders</i> American psychiatric classification and diagnostic guide

The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria.

Asperger syndrome Neurodevelopmental disorder

Asperger syndrome (AS), also known as Asperger's, is a neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior and interests. It is an autism spectrum disorder (ASD), but differs from other ASDs by relatively unimpaired language and intelligence. The syndrome is named after the Austrian pediatrician Hans Asperger, who, in 1944, described children in his care who struggled to form friendships, did not understand others' gestures or feelings, engaged in one-sided conversations about their favourite interests, and were clumsy. Although not required for diagnosis, physical clumsiness and unusual use of language are common. Signs usually begin before two years of age and in many cases never resolve.

Tourette syndrome Neurodevelopmental disorder involving motor and vocal tics

Tourette syndrome or Tourette's syndrome is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency. Tourette's is at the more severe end of a spectrum of tic disorders. The tics often go unnoticed by casual observers.

The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), is a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. The pervasive developmental disorders include autism, Asperger syndrome, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder (CDD), overactive disorder associated with mental retardation and stereotyped movements, and Rett syndrome. The first four of these disorders are commonly called the autism spectrum disorders; the last disorder is much rarer, and is sometimes placed in the autism spectrum and sometimes not.

Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks. Coprolalia comes from the Greek κόπρος (kópros), meaning "dung, feces", and λαλιά (laliā́) "speech", from λαλεῖν (laleîn) "to talk".

Tic Repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups

A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups. Tics can be invisible to the observer, such as abdominal tensing or toe crunching. Common motor and phonic tics are, respectively, eye blinking and throat clearing.

A pervasive developmental disorder not otherwise specified (PDD-NOS) is one of the four autistic disorders (AD) in the DSM-5 and also was one of the five disorders classified as a pervasive developmental disorder (PDD) in the DSM-IV. According to the DSM-4, PDD-NOS is a diagnosis that is used for "severe or pervasive impairment in the development of reciprocal social interaction and/or verbal and nonverbal communication skills, or when stereotyped behavior, interests, and/or activities are present, but the criteria are not met for a specific PDD" or for several other disorders. PDD-NOS includes atypical autism, because the criteria for autistic disorder are not met, for instance because of late age of onset, atypical symptomatology, or subthreshold symptomatology, or all of these. Even though PDD-NOS is considered milder than typical autism, this is not always true. While some characteristics may be milder, others may be more severe.

PANDAS Hypothesis in pediatric medicine

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a controversial hypothetical diagnosis for a subset of children with rapid onset of obsessive-compulsive disorder (OCD) or tic disorders. Symptoms are proposed to be caused by group A streptococcal (GAS), and more specifically, group A beta-hemolytic streptococcal (GABHS) infections. OCD and tic disorders are hypothesized to arise in a subset of children as a result of a post-streptococcal autoimmune process. The proposed link between infection and these disorders is that an autoimmune reaction to infection produces antibodies that interfere with basal ganglia function, causing symptom exacerbations, and this autoimmune response results in a broad range of neuropsychiatric symptoms.

Stereotypic movement disorder (SMD) is a motor disorder with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior, that markedly interferes with normal activities or results in bodily injury. To be classified as SMD, the behavior in question must not be due to the direct effects of a substance, Autism, or another medical condition. The cause of this disorder is not known.

Causes and origins of Tourette syndrome have not been fully elucidated. Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of multiple motor tics and at least one phonic tic, which characteristically wax and wane. Tourette's syndrome occurs along a spectrum of tic disorders, which includes transient tics and chronic tics.

Klazomania refers to compulsive shouting; it has features resembling the complex tics such as echolalia, palilalia and coprolalia seen in tic disorders, but has been seen in people with encephalitis lethargica, alcohol use disorder, and carbon monoxide poisoning. It was first reported by L. Benedek in 1925 in a patient with postencephalitic parkinsonism. Little is known about the condition, and few cases have been reported.

History of Tourette syndrome Aspect of history

Tourette syndrome is an inherited neurological disorder that begins in childhood or adolescence, characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic.

DSM-5 2013 fifth and current edition of the Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.

Personality disorder not otherwise specified is a diagnostic classification for some DSM-IV Axis II personality disorders not otherwise listed in DSM-IV.

Mental disorders diagnosed in childhood are divided into two categories: childhood disorders and learning disorders. These disorders are usually first diagnosed in infancy, childhood, or adolescence, as laid out in the DSM-IV-TR and in the ICD-10. The DSM-IV-TR includes ten subcategories of disorders including mental retardation, Learning Disorders, Motor Skills Disorders, Communication Disorders, Pervasive Developmental Disorders, Attention-Deficit and Disruptive Behavior Disorders, Feeding and Eating Disorders, Tic Disorders, Elimination Disorders, and Other Disorders of Infancy, Childhood, or Adolescence.

Several factors complicate the diagnosis of Asperger syndrome (AS), an autism spectrum disorder (ASD). Like other ASD forms, Asperger syndrome is characterized by impairment in social interaction accompanied by restricted and repetitive interests and behavior; it differs from the other ASDs by having no general delay in language or cognitive development. Problems in diagnosis include disagreement among diagnostic criteria, the controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis for non-technical reasons. As with other ASD forms, early diagnosis is important, and differential diagnosis must consider several other conditions.

A somatic symptom disorder, formerly known as a somatoform disorder, is any mental disorder that manifests as physical symptoms that suggest illness or injury, but cannot be explained fully by a general medical condition or by the direct effect of a substance, and are not attributable to another mental disorder. Somatic symptom disorders, as a group, are included in a number of diagnostic schemes of mental illness, including the Diagnostic and Statistical Manual of Mental Disorders.

Motor disorders are disorders of the nervous system that cause abnormal and involuntary movements. They can result from damage to the motor system.

Other specified dissociative disorder (OSDD) is a mental health diagnosis for pathological dissociation that matches the DSM-5 criteria for a dissociative disorder, but does not fit the full criteria for any of the specifically identified subtypes, which include dissociative identity disorder, dissociative amnesia, and depersonalization/derealization disorder, and the reasons why the previous diagnoses were not met are specified. "Unspecified dissociative disorder" is given when the clinician does not give a reason. The International Statistical Classification of Diseases and Related Health Problems (ICD-10) refers to the diagnosis as "Other dissociative and conversion disorders". Under the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), it was known as "Dissociative disorder not otherwise specified" (DDNOS).

References

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  2. Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. "Tourette syndrome and tic disorders: a decade of progress". J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):947–68 doi : 10.1097/chi.0b013e318068fbcc PMID   17667475
  3. 1 2 3 4 5 6 7 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp.  81–85. ISBN   978-0-89042-555-8.
  4. 1 2 "Highlights of changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 2013. Archived from the original (PDF) on February 3, 2013. Retrieved June 5, 2013.
  5. Robertson MM, Eapen V (October 2014). "Tourette's: syndrome, disorder or spectrum? Classificatory challenges and an appraisal of the DSM criteria" (PDF). Asian J Psychiatr (Review). 11: 106–13. doi:10.1016/j.ajp.2014.05.010. PMID   25453712.
  6. ICD Version 2006. World Health Organization. Retrieved on 2007-05-24.
  7. Roessner V1, Plessen KJ, Rothenberger A, et al. "European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment". Eur Child Adolesc Psychiatry. 2011 Apr;20(4):173-96. PMID   21445724.
  8. 1 2 Black KJ, Black ER, Greene DJ, Schlaggar BL. Provisional Tic Disorder: What to tell parents when their child first starts ticcing. F1000Research 2016, 5:696 doi : 10.12688/f1000research.8428.1
  9. 1 2 Tourette Syndrome Fact Sheet. National Institutes of Health (NIH). Retrieved on 2005-03-23.
  10. Swerdlow NR. "Tourette syndrome: current controversies and the battlefield landscape". Current Neurology and Neuroscience Reports. 5 (5): 329-31. doi : 10.1007/s11910-005-0054-8 PMID   16131414
  11. Evidente VG. "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders". Postgraduate medicine. 108 (5): 175-6, 179-82. PMID   11043089 Retrieved on 2007-05-24
  12. Neurodevelopmental disorders. American Psychiatric Association. Retrieved on December 29, 2011.
  13. Moran, M. "DSM-5 provides new take on neurodevelopment disorders". Psychiatric News. January 18, 2013;48(2):6–23. doi : 10.1176/appi.pn.2013.1b11
  14. Ellis CR, Pataki C. "Background: Childhood Habit Behaviors and Stereotypic Movement Disorder". Medscape. Retrieved October 6, 2013.
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  16. Black, KJ. ADHD medications and tics. February 17, 2018. tics.wustl.edu/adhd-medications-and-tics/