TIC DISORDER , diagnosis, treatment.pptx

Definition
A tic is an uncontrolled sudden, repetitive movement or sound thatcan be hard to control.
Tics are sudden twitches, movements, or sounds that people do repeatedly.
People who have tics cannot stop their body from doing these things.
For example, a person with a motor tic might keep blinking over and over, or a person with a vocal tic might make a grunting sound unwillingly.

1. TIC DISORDER

2. WHAT IS TIC DISORDER? Definition A tic is an uncontrolled sudden, repetitive movement or sound thatcan be hard to control. Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person with a motor tic might keep blinking over and over, or a person with a vocal tic might make a grunting sound unwillingly.

3. WHAT IS TIC DISORDER? Three tic disorders are included in the  DSM-5-TR : Tourette syndrome (TS, sometimes called Tourette disorder) Persistent (sometimes called chorionic) motor or vocal tic disorder. Provisional tic disorder.

4. TIC DISORDER Association with suicidal thoughts Suicidal thoughts and behaviors were significantly associated with tic symptom severity T ic-related impairment and obsessive-compulsive D epressive A nxiety and attention-deficit/hyperactivity disorder symptom severity

5. TIC DISORDER Functional consequences Functional Tics are caused by a "miscommunication" within the brain, where your brain gets stuck in a loop, causing your body to receive the wrong signals. ​ Functional neurological disorder (FND) describes a problem with how the brain receives and sends information to the rest of the body.

6. TIC DISORDER Differential diagnosis Tics also need to be distinguished from other neurological movement disorders (chorea, myoclonus and dystonia). Tics also need to be distinguished from movement disorders associated with psychiatric conditions (compulsions, stereotypies, mannerisms, and habits). Tourette syndrome (TS) is part of a family of primary tic disorders that include chronic motor or vocal tic disorder and transient tic disorder.

7. TIC DISORDER Comorbidity The treatment of comorbid conditions in tic disorder is important. About 35% of individuals will also have co-morbid obsessive-compulsive disorder (while up to 90% will have obsessive-compulsive symptoms).

8. TIC DISORDER Comorbidity OCD symptoms also tend to be different when there are co-morbid tics. For example, there may be more sensory phenomena sexual, violent, religious and symmetry themes, and “tic-like” compulsions Other comorbid conditions include: ADHD (50%), autism spectrum disorder (10%), and a mood, anxiety, or disruptive behavior (30%).[3] Only about 10% will not have any comorbidity.

9. TIC DISORDER Other specified and Unspecified Other specified and Unspecified: for tic disorders that result in significant impairment to the individual yet do not meet the full criteria for other tic disorders.  The new categories account for tics with onset in adulthood, or tics triggered by other medical conditions or illicit drug use.

10. TIC DISORDER Treatment Canadian guidelines for the evidence-based treatment of tic disorders: Pharmacotherapy: The Canadian journal of psychiatry, 57(3), 133-143.Canadian guidelines for the evidence based treatment of Tourette syndrome.

11. TIC DISORDER Treatment Education: Education and support for the patient's family and school is a first-line treatment. Remember as a clinician to educated families that the natural history of tics is that they wax and wane, which can confound medication treatment. It’s possible the tics will get worse, despite treatment. Take your time.

12. TIC DISORDER Treatment Behavioral: Habit reversal therapy (HRT) is a behavioral treatment used to reduce repetitive behaviors. It is a second line treatment for Tourette's, after providing education about the disorder. Medications: Pharmacotherapy is primarily with alpha-2 agonists or antipsychotics. Note that rebound hypertension can occur if clonidine is stopped abruptly and not tapered.