What is Chronic Motor or Vocal Tic Disorder?
A type of tic disorder in which there are or were multiple motor tics and one or more vocal tics that do not occur simultaneously. Almost always there is a beginning in childhood or adolescence. Characteristic is the development of motor tics in front of voice tics. Symptoms often worsen during adolescence, characterized by the persistence of elements of the disorder in adulthood.
Causes of Chronic Motor or Voice Tic Disorder
A large role is played by both genetic factors and disorders of the neurochemical function of the central nervous system.
A combination of chronic motor or voice tics occurs in 1.6% of the population.
Symptoms of Chronic Motor or Vocal Tic Disorder
Characteristic is the presence of either motor or voice tics, but not both together. Ticks appear many times a day, almost every day or periodically for more than one year. Start at the age of 18. Tics appear not only during intoxication with psychoactive substances or due to known diseases of the central nervous system (for example, Huntington’s disease, viral encephalitis). Types of ticks and their localization are similar to transient ones. Chronic vocal tics are less common than chronic motor tics. Voice tics are often not loud and not strong, consist of the noise created by the contraction of the larynx, abdomen, diaphragm. Rarely are they multiple with explosive, repetitive vocalizations, coughing, grunting. Like motor tics, voice tics can be spontaneously suppressed for a while, disappear during sleep and intensify under the influence of stress factors. The prognosis is slightly better in children who become ill at the age of 6-8 years. If tics cover the limbs or trunk, and not just the face, the prognosis is usually worse.
Diagnosis of Chronic Motor or Vocal Tic Disorder
It is also necessary to carry out with tremor, mannerism, stereotypes or disorders in the form of bad habits (tilting the head, swaying the body), more common in childhood autism or mental retardation. The arbitrary nature of stereotypy or bad habits, the absence of subjective grief over the disorder distinguishes them from ticks. Treatment of attention deficit hyperactivity disorder with psychostimulants enhances existing tics or accelerates the development of new tics. However, in most cases, after drug withdrawal, tics stop or return to the level before treatment.
Treatment of Chronic Motor or Vocal Tic Disorder
It depends on the severity and frequency of ticks, subjective experiences, secondary disorders at school and the presence of other concomitant psychotic disorders.
The main role in the treatment is psychotherapy.
Small tranquilizers are ineffective. Haloperidol is effective in some cases, but the risk of side effects of this drug, including the development of tardive dyskinesia, should be considered.