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Tic disorder
Specialty	Psychiatry

Tic disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic, stereotyped, involuntary movements). Tic disorders are defined similarly by the World Health Organization (ICD-10 codes).

Classification

Tic disorders are classified as follows:

• Transient tic disorder consists of multiple motor and/or phonic tics with duration of at least 4 weeks, but less than 12 months.
• Chronic tic disorder is either single or multiple motor or phonic tics, but not both, which are present for more than a year.
• Tourette's disorder is diagnosed when both motor and phonic tics are present for more than a year.
• Tic Disorder NOS is diagnosed when tics are present, but do not meet the criteria for any specific tic disorder.

Tic disorders onset in childhood (before the age of 18), and are not due to the effects of medication or another medical condition.

DSM-IV-TR diagnosis codes for the tic disorders are:

• 307.20 Tic Disorder NOS (Not Otherwise Specified)
• 307.21 Transient Tic Disorder
• 307.22 Chronic Motor or Vocal Tic Disorder
• 307.23 Tourette's Disorder

ICD10 diagnosis codes are:

• F95.0 Transient tic disorder
• F95.1 Chronic motor or vocal tic disorder
• F95.2 Combined vocal and multiple motor tic disorder
• F95.8 Other tic disorders
• F95.9 Tic disorder, unspecified

Prevalence

A large, community-based study suggested that over 19% of school-age children have tic disorders. The children with tic disorders in that study were usually undiagnosed. (Kurlan) As many as 1 in 100 people may experience some form of tic disorder, usually before the onset of puberty. (NIH) Tourette syndrome is the more severe expression of a spectrum of tic disorders, which are thought to be due to the same genetic vulnerability. Nevertheless, most cases of Tourette syndrome are not severe. Although a significant amount of investigative work indicates genetic linkage of the various tic disorders, further study is needed to confirm the relationship.

Treatment

Treatment of tic disorders, although not usually necessary, is similar to treatment of Tourette syndrome. Tics should be distinguished from other causes of tourettism.

Notes

1. American Psychiatric Association (2000). DSM-IV-TR: Tourette's Disorder. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision (DSM-IV-TR), ISBN 0890420254. Available at BehaveNet.com Retrieved on August 10, 2009.
2. Swain JE, Scahill L, Lombroso PJ, King RA, Leckman JF. "Tourette syndrome and tic disorders: a decade of progress". J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):947–68 PMID 17667475
3. Evidente VG. "Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders". Postgraduate medicine108 (5): 175-6, 179-82. PMID 11043089 Retrieved on 2007-05-24
4. DSM-IV-TR: numerical listing of codes and diagnoses. BehaveNet Clinical Capsule. Retrieved on 2007-05-24.
5. ICD Version 2006. World Health Organization. Retrieved on 2007-05-24.
6. Kurlan R, McDermott MP, Deeley C, et al. "Prevalence of tics in schoolchildren and association with placement in special education". Neurology 57 (8): 1383-8. PMID 11673576
7. Swerdlow NR. "Tourette syndrome: current controversies and the battlefield landscape". Current neurology and neuroscience reports. 5 (5): 329-31. PMID 16131414

References

• Tourette Syndrome Fact Sheet. National Institutes of Health (NIH). Retrieved on 2005-03-23
• The Tourette Syndrome Classification Study Group. "Definitions and classification of tic disorders". Arch. Neurol. 50 (10): 1013-6. PMID 8215958. Retrieved on 2005-03-22

• Mental illness diagnosis by DSM and ICD
• Tourette syndrome