Sandbox/Persistent (chronic) Motor or Vocal Tic Disorder

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Diagnostic Criteria

DSM-V Diagnostic Criteria for

“

A.Single or multiple motor or vocal tics have been present during the illness, but not both motor and vocal. AND B.The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset. AND C.Onset is before age 18 years. AND D.The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington’s disease, post viral encephalitis). AND E.Criteria have never been met for Tourette’s disorder. Specify if: With motor tics only With vocal tics only

”

Natural History,Prognosis and Complications

Prognosis

• Good prognostic factors include:

• Focused activities

• Calm
• Engaged in schoolwork
• Tasks at work

• Poor Prognostic factors include:

• Anxiety
• Excitement
• Exhaustion
• Lower birth weight
• Maternal smoking during pregnancy

• Obstetrical complications
• Older paternal age

• tasks at work

• Stressful/exciting events

Differential Diagnosis

• Abnormal movements that may accompany other medical conditions and stereotypic movement disorder

• Repetitive hand waving/rotating,arm flapping
• Finger wiggling

• Myoclonus
• Obsessive-compulsive and related disorders
• Substance-induced and paroxysmal dyskinesias

• Choreoathetoid movements
• Dystonic movement