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    How can motor tic disorder be treated?

Posted on Mon, 31 Jul 2017 in Brain and Spine
Question: my son has motor tics problem from last 3 years but its not regular it stops in between for long (some months) but in between he started again for some days and again stop for months but in thses days he is doing more often and for long duration .kindly advice
Answered by Dr. Olsi Taka 37 minutes later
Brief Answer:
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Detailed Answer:
I read you question carefully and I understand your concern.

One question, is the provided age of 44 the age of your son, or yours. It should be the age of the patients, but since tics are more common in childhood was wondering if perhaps you've mistakenly put your age, happens often.

The first measure to handle tics is to try to avoid stressful situations which provoke anxiety. Avoiding fatiguing, maintaining a regular sleeping and eating habit is also important.
If that is not enough then psychotherapy may be attempted, behavioral therapy, learning techniques to relax and suppress the urges.
When medication is considered as a last resort (tics affect quality of life and above measures do not work) there are several possibilities, which include antipsychoptics, clonidine or tetrabenazine. When limited to a particular muscle group botulinum toxin injections are also to be considered.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Olsi Taka 7 hours later
his age is 10 years and he is not doing on regulary but suddenly he started for some weeks and tgen stop for months
Answered by Dr. Olsi Taka 9 hours later
Brief Answer:
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Detailed Answer:
Thank you for the additional information, with an age of 10 things make much more sense now.
The current worsening is not an unexpected phenomenon, tics tend to have a waxing and waning course with many flucuations. With their origin of the tics still remaining not clear to medicine the cause of these fluctuations is unclear as well, stress and anxiety are known contributors but fluctuations happen even in their absence. It is nothing to panic about, it is common.

As for treatment what I said above remains the same. It is preferable to avoid medication unless necessary. There is no cure, medication is used only to contain the symptoms, hence only if the symptoms really affect quality of life. Generally it is preferable to start with alternatives like Clonidine, Guanfacine, Clonazepam, Baclofen. If not effective medication like antipsychotics (more effective but more potential for side effects) are used. Once symptoms are adequately controlled for some time it may be attempted to withdraw medication.

The good news is that tics improve with age, after the age of 18 in about 26% they disappear, are signficantly reduced in about 46% and only in a minority of patients remain unchanged.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka


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