Desmond Kaplan MD FAPA

Child, Adolescent & Adult Psychiatry

1777 Reisterstown Road, Suite 50
 Baltimore, MD 21208

Chronic Motor or Vocal Tic Disorder

Chronic (or persistent) motor or vocal tic disorder is characterized by an ongoing problem with involuntary vocal outbursts or sudden, rapid movements which interfere with daily life. More common than Tourette syndrome, chronic motor tic disorder involves either vocal outbursts or sudden movements, but not both.

Tics usually begin in childhood at age 5 or 6 and worsen until puberty. Often, there is improvement in the condition during the adult years. If the tic disorder only continues to be problematic for several months to a year, it is referred to as provisional, or transitional, motor or vocal tic disorder.

Symptoms of Chronic Tic Disorder

The tics that are symptoms of chronic motor or vocal tic disorder are uncontrollable sudden rapid movements or vocalizations. These may include:

  • Excessive blinking
  • Facial grimaces
  • Shoulder shrugs
  • Sudden jerky movements of any part of the body, often the arms or legs
  • Abrupt, unexpected vocalizations such as grunts, throat clearing, barking or shouting
  • Contractions of the diaphragm or abdomen with associated sounds

Some patients with chronic motor tic disorder have several kinds of tics. Typically, patients with this disorder can stifle their tics temporarily, but eventually must give in to an uncontrollable urge, experiencing relief when they do so. Sometimes, one tic may fade out and another may become develop. Symptoms of chronic motor tic disorder may continue during sleep and may worsen with:

  • Excitement or agitation
  • Fatigue or sleep deprivation
  • Elevated temperature
  • Stress or trauma

Diagnosis of Chronic Tic Disorder

In diagnosing the disorder, doctors focus on the age of onset, the duration and severity of the problem, and whether the tics are motor or vocal. Although evidence of chronic motor tic disorder can be easily observed during examination, in order for the condition to be professionally diagnosed, it must meet these criteria:

  • The tics must have been in evidence nearly every day for more than a year
  • The patient must not have been free of symptoms for longer than 3 months
  • The problem must have started before the patient was 18 years of age
  • The tics are not caused by another disease or by medication or drugs
  • The patient must not have been diagnosed with Tourette syndrome

Treatment of Chronic Tic Disorder

While there are medications to relieve the symptoms of this disorder, these medications may have troubling side effects, including problems with movement or thought. Treatment depends on how severe or disabling the condition is. Studies have shown some successful alleviation of symptoms with behavioral therapy. Other forms of psychotherapy may be useful in helping patients cope with concomitant problems with social interactions. There is some evidence that addressing the problem early in childhood provides better therapeutic results.

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