Beyond the ‘tic’ king clock: a case report on adult onset tic disorder
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241510Keywords:
Tic disorder, Adult onset, Psychogenic hiccup, Other specified tic disorder, Primary tic disorderAbstract
Tic is rapid recurrent non-rhythmic motor movement or vocalization; movement of limbs or other body parts is known as motor tic and involuntary repetitive sound like grunting sniffing throat clearing is known as a vocal tic. Tic is a neurodevelopmental disorder and has its onset in the developmental period. According to diagnostic and statistical manual of mental illnesses (DSM) 5, tic should have its onset before 18 years of age and can resolve with proper treatment. In this case, a 23-year-old female presented with recurrent abnormal throat clearing and excessive loud sounds which started for the last 1 year. Initially, she was diagnosed with psychogenic hiccup in another department and was treated with Baclofen 30 mg for 1 month but as no improvement was observed later she was referred to psychiatry outpatient department (OPD) for further treatment where she was diagnosed with adult onset vocal tic with a premonitory urge for tics scale (PUTS) score of 27 on admission and she was treated with tablet Risperidone 2 mg and after 4 weeks of treatment all symptoms subside and PUTS score came to be 6 at the time of discharge.
References
American Psychiatric Association. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision. 2022. Available at: https://www.appi.org/Products/DSM-Library/Diagnostic-and-Statistical-Manual-of-Mental-Di-(1). Accessed on 12 March 2024.
Sadock BJ. Kaplan and Sadock's Comprehensive Textbook of Psychiatry- 10th Edition. Wolters Kluwer. 2023.
Singer H, Mink J, Gilbert D, Jankovic J. Movement Disorders in Childhood. 2nd Edition. Elsevier: London, UK. 2016;40-55.
Shprecher DR, Kious BM, Himle MH. Advances in mechanistic understanding and treatment approaches to Tourette syndrome. Discov Med 2015;20:295-301.
Zheng W, Li XB, Xiang YQ, Zhong BL, Chiu HF, Ungvari GS, et al. Aripiprazole for Tourette's syndrome: a systematic review and meta-analysis. Hum Psychopharmacol. 2016;31(1):11-8.
Andrade P, Visser-Vandewalle V. DBS in Tourette syndrome: where are we standing now? J Neural Transm (Vienna). 2016;123:791-6.
Bloch MH, Leckman JF. Clinical course of Tourette syndrome. J Psychosom Res. 2009; 67(6):497-501.
Garcia-Delgar B, Servera M, Coffey BJ, Lázaro L, Openneer T, Benaroya-Milshtein N, et al. Tic disorders in children and adolescents: does the clinical presentation differ in males and females? A report by the EMTICS group. Eur Child Adolesc Psychiatry. 2022;31(10):1539-48.
Kumar R, Lang AE. Secondary tic disorders. Neurol Clin. 1997;15:309-31.
Mejia NI, Jankovic J. Secondary tics and tourettism. Rev Bras Psiquiatr. 2005;27:11-7.
Chouinard S, Ford B. Adult onset tic disorders. J Neurol Neurosurg Psychiatry. 2000;68:73843.
Sacks OW. Acquired tourettism in adult life. Adv Neurol. 1982;35:89-92.
Factor SA, Molho ES. Adult-onset tics associated with peripheral injury. Mov Disord. 1997;12:1052-5.
Robakis D. How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features. Tremor Other Hyperkinet Mov (N Y). 2017;7:441.
Goetz CG, Tanner CM, Stebbins GT, Leipzig G, Carr WC. Adult tics in Gilles de la Tourette’s syndrome: Description and risk factors. Neurology. 1992;42:784-8.
