title: The management of tics.
abstract: A tic is a stereotyped repetitive involuntary movement or sound, frequently preceded by premonitory sensations or urges. Most tic disorders are genetic or idiopathic in nature, possibly due to a developmental failure of inhibitory function within frontal-subcortical circuits modulating volitional movements. Currently available oral medications can reduce the severity of tics, but rarely eliminate them. Botulinum toxin injections can be effective if there are a few particularly disabling motor tics. Deep brain stimulation has been reported to be an effective treatment for the most severe cases, but remains unproven. A comprehensive evaluation accounting for secondary causes, psychosocial factors, and comorbid neuropsychiatric conditions is essential to successful treatment of tic disorders.
authors.affiliation: Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14620, USA.
authors.forename: David
authors.initials: D
authors.lastname: Shprecher
authors.forename: Roger
authors.initials: R
authors.lastname: Kurlan
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy; D001521:Behavior Therapy; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications; D002648:Child; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D003937:Diagnosis, Differential; D019468:Disease Management; D015259:Dopamine Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D001523:Mental Disorders / Q000150:complications; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000188:drug therapy; D010353:Patient Education as Topic; D019956:Stereotypic Movement Disorder / Q000175:diagnosis; D020323:Tics / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000316:Adrenergic alpha-Agonists; D014150:Antipsychotic Agents; D015259:Dopamine Agents; D019274:Botulinum Toxins, Type A