Tics and Tourette: Pre-test

The video will be shown after completion of the pre-test. Thank you.

1. An 8-year-old boy is brought to the office for evaluation of recurrent rapid, brief, non-rhythmic movements. The onset was about 2-3 years ago; initially, he had repetitive eye blinking that lasted for about 6-8 months and then subsided. In the interim, he experienced recurrent nose scrunching, but his parents became concerned as he recently started to have repetitive head turning and shoulder shrugging and also is complaining of some neck pain. These movements appear to be semi-voluntary, and he can control them for a time, but eventually, he feels compelled to let go. The movements worsen with stress, anxiety, and excitement. Based on the information provided, what is the most likely diagnosis?

2. You follow a 12-year-old boy in the clinic with a diagnosis of chronic motor tic disorder. Today, he presents with an increase in the frequency of his motor tics and some new vocal tics, which have contributed to his anxiety. His parents are also concerned about bullying at school. Additionally, he is struggling with school performance and was recently diagnosed with ADHD. They want to discuss management options for his tics. What is the most reasonable treatment option?

3. Which of the following comorbidities are most commonly associated with Tourette syndrome?