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Neurology (Expert Forum)
Complex tics or Tourette Syndrome ?
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Complex tics or Tourette Syndrome ?
by LAP69, Feb 08, 2006 12:00AM
I have a 4 ˝ year old son. 14 months ago we saw him blinking often (both eyes) especially when watching TV. An eye doc said he’s stressed; we gave the child a break and he improved in ~ 2 months. He seemed to be tic-free for ~ 7 months; last Nov. he had a cold & he’s been clearing his throat since. A PCP said it was due to the cough, sore throat, & gave him antibiotics (no result). By mid-Dec. he re-started blinking, sometimes with eye rolling & even head jerking. The onset of the motor tics coincided with a Christmas pageant where he had to recite a poem and he was nervous about it. He had a rough year, grandpa died (spring) & he had a baby sister born (fall); the vocal tics started roughly when we stopped having help at home, maybe he feels lonely - the parents are playing less with him, he gets less attention.
We’ve spent more time with him lately, & the tic frequency decreased. The motor tics diminished in intensity, but the vocal tics got more complex – sometimes sounding like humming. He doesn’t tic in preschool, when busy, or asleep. It gets worse when he’s upset or tired (evenings), when looking over books or watching TV. His PCP noticed his blinking (not the vocal tics) & told us not to worry. He’s a very smart child & has a great memory. There’s no family history of Tourette’s, & he was tic-free for many months last year. We’d like to get a correct diagnostic (advice for a specialist would be appreciated - we live in Boston, but we could travel), but we’re also concerned about the meds’ side effects & if the diagnostic on this record might hurt him in the future.
We’ve spent more time with him lately, & the tic frequency decreased. The motor tics diminished in intensity, but the vocal tics got more complex – sometimes sounding like humming. He doesn’t tic in preschool, when busy, or asleep. It gets worse when he’s upset or tired (evenings), when looking over books or watching TV. His PCP noticed his blinking (not the vocal tics) & told us not to worry. He’s a very smart child & has a great memory. There’s no family history of Tourette’s, & he was tic-free for many months last year. We’d like to get a correct diagnostic (advice for a specialist would be appreciated - we live in Boston, but we could travel), but we’re also concerned about the meds’ side effects & if the diagnostic on this record might hurt him in the future.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Feb 11, 2006 12:00AM
Tourette's syndrome is diagnosed clinically by vocal and non-vocal tics over at least a year in a child under the age of 18 years, and causing some social impairment etc
Try Tourettes-disorder.com for more information
throat clearing is a common vocal tic, and humming would also be considered a vocal tic. I agree that the correct diagnosis is crucial and he should see a pediatric neurologist. Tourettes does not cause significant problems with intelligence etc - one of my neurology colleagues has it.
There is effective medication available which are generally well tolerated without long term side effects and it may be appropriate to treat your child if the neurologist recommends. The diagnosis should not prevent him from attaining anything he wants to in life, particularly if diagnosed and treated effectively
Good luck
Try Tourettes-disorder.com for more information
throat clearing is a common vocal tic, and humming would also be considered a vocal tic. I agree that the correct diagnosis is crucial and he should see a pediatric neurologist. Tourettes does not cause significant problems with intelligence etc - one of my neurology colleagues has it.
There is effective medication available which are generally well tolerated without long term side effects and it may be appropriate to treat your child if the neurologist recommends. The diagnosis should not prevent him from attaining anything he wants to in life, particularly if diagnosed and treated effectively
Good luck
Aarons special needs showed them self through his school work. Aaron vever liked going to pre school and had a reall struggle going to school. Aaron was a quite lad that seemed to be popular but did not seem to mix only when it suited him
He still confinds him self to the house and will not join in with hobbies of any kind such as sport ,altough he is good at sport when tries. When he was young aaron broke things in a rage of temper when he could not do things and that has followed through till now. He bangs his head and head butts doors walls. He screams and shouts and then crys he dose not seem to beable to cope with following intructions and finds it hard to explain things in any detail. He trys so hard with home work but leads to shouting and home work been rippted up.He finds things really hard and frustrating. Also he has obssetions about diffrent things and has also started fires in the house which is very upsetting. Aaron sleeps ok when finley gets settled which takes him some time to get to sleep.When his tick presents its self his behaviour can get very excitable and annoying.Recently over the six months aaron has found to have mild learning difficuties and mentle develoment delay. I still have had no information on this and how it can effect him also with his tick occuring often this is causing him to be quite irratable and hypo. We try and reason with him but some times just dose not listen. I am concerned as aaron is 12 now and do not want behaviours to get out of my controll. AAaon always have to be the joker we find him funny as he is so funny at times but others may not find his sense of humer funny a tall but quite frustrating. We have learnt to cope with aarons behaviour and think of diffrent methods to talk to him, I doint expect a miracle but just for some one to under stand his diffculties and support him. Also he has periods which he shouts out and blows rasberrys.at 12 this is not acccetable.He swings on chairs and will not listen in class and fidgits around not really listening.