Answer to the last #DiagnosticDilemma
A 6-Year-Old Boy With Excessive Fidgeting

Correct answer: D. Tic disorder

This boy's presentation with echolalia, where he imitates his mother, and stereotyped muscle contractions such as eye blinking, repetitive frowning, head shaking, and throat clearing are suggestive of a tic disorder. Tic disorders are characterized by recurrent and stereotyped muscle contractions. The most well-known tic disorder is Tourette syndrome.

In this case, the boy most likely has Tourette syndrome. Individuals usually present with stereotyped motor and vocal tics and behavioral symptoms, such as attention deficit hyperactivity disorder or obsessive compulsive disorder. Tic disorders are common among children and adolescents aged 2-15 years. In the majority of these boys and girls, tics often disappear with time.

Children with tic disorders may experience an irresistible urge to express tics but can voluntarily suppress them for short periods of time. Medical therapy is indicated when tics interfere with social interaction or quality of life or if they cause physical pain. The mainstay therapy for Tourette syndrome centers on education, behavioral therapy, and medications like guanfacine and clonidine.

Major Takeaway:
This boy has echolalia, where he imitates his mother, and stereotyped muscle contractions, and together these are suggestive of a tic disorder.


The #DiagnosticDilemma question can be accessed here: