Motor Tic Disorder
Tics are defined as brief, intermittent, nonrhythmic, unpredictable, purposeless movements (motor tics) or sounds (phonic or vocal tics). They are frequently associated with a subjective urge to carry out the tic. Voluntary suppression results in psychic tension and anxiety which are relieved with the “release” created by executing the movements or sounds. The diagnosis of Tourette syndrome requires the presence of both motor and vocal or verbal tics (see Chap. 109).
Tics are classified as simple or complex. Simple motor tics are focal movements involving one group of muscles such as eye blinking, tongue protrusion, facial grimacing, shoulder shrugging, and head turning. Complex motor tics are coordinated or sequential patterns of movements that may resemble normal motor tasks or gestures.
Clip 1: the patient exhibits increased eye blinking frequency and repetitive frowning which increase while carrying out rapid movements. Clip 2: another 14-year-old boy displays complex motor tics with sequential large amplitude rotational and hyperextension head movements, arm twisting, shoulder shrugging, and jumping and twisting leg movements. He reports that the movements are painful, but that he is unable to voluntarily stop them. He lacks vocal tics.
Motor tic disorder.mp4 (MP4 32,862KB)