title: Botulinum toxin to control an incapacitating tic in a child with a clavicular fracture.
abstract: We present the case of an 11-year-old boy who suffered from an undefined tic disorder and incidentally sustained a traumatic fracture of the clavicle. The fracture healing course was complicated by the tic activity, and the frequency and intensity of the tics were worsened by the presence of clavicular pain. He underwent surgery and his management required the collaboration of orthopaedic surgeons, the Acute Pain Service, neurologists for tic management and rehabilitation physicians who performed the intramuscular injections of botulinum toxin. We recommend a multidisciplinary and multimodal approach to managing patients suffering from tic disorders and highlight the consideration of intramuscular injections of botulinum toxin, which were successful for this patient.
authors.affiliation: Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, Western Australia, Australia. yuping_chen@hotmail.com
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: P
authors.initials: P
authors.lastname: Thalayasingam
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use*; D002648:Child; D002968:Clavicle / Q000293:injuries*; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D020323:Tics / Q000188:drug therapy*
chemical_list: D001905:Botulinum Toxins