Tourette Syndrome: The Daily PANCE Blueprint

Home Tourette Syndrome: The Daily PANCE Blueprint

Tourette Syndrome: The Daily PANCE Blueprint

A 7-year-old boy is brought to the office by his parents for evaluation of unusual behaviors. For the past year, the patient has had frequent episodes of shoulder shrugging and head shaking. These behaviors become more pronounced when he is anxious and seem to lessen when he is focused on reading. Due to these behaviors, he has difficulty making friends at school as other children tease him. During the evaluation, the patient occasionally clears his throat and grimaces. When asked about this, he says he cannot stop pretending to be a robot. His parents state that he has been "acting like a robot" every day for the past month. Physical examination, including a neurological exam, is unremarkable. Which of the following is the most likely diagnosis in this patient?

A. Autism spectrum disorder
B. Attention-deficit/hyperactivity disorder (ADHD)
C. Tourette syndrome
D. Obsessive-compulsive disorder (OCD)
E. Childhood schizophrenia

Answer and topic summary

The answer is C. Tourette syndrome

Tourette syndrome is the most likely diagnosis in this patient. It is characterized by multiple motor tics (e.g., shoulder shrugging, head shaking) and at least one vocal tic (e.g., throat clearing) that have been present for more than one year. These tics often fluctuate in frequency and severity and can be exacerbated by stress or excitement. The description of the patient’s behaviors, including acting out like a robot, aligns with the typical presentation of Tourette syndrome.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Neurology ⇒ Movement Disorders (PEARLS) ⇒ Tourette disorder

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